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The doctor is an "in network" physician, so she definitely has a contract with the insurance company to see and treat patients who have the insurance. The question is whether the doctor's office can require the patient to file the insurance claim, rather than filing the claim for the patient. I believe the doctor is required to file the claim? Am I right about this, or do I have to file my own claim?
I thought if the doctor was part of the insurance network, and agreed to take patients from that network (in this case a PPO network), that to become part of the insurance network the doctor had to agree to file claims for her services with that insurance company. However, it sounds from what you said like it is a question of what contractual obligations the doctor has with that insurance company. Is it possible that an insurance company would allow a doctor to participate with the insurance but at the same time say that the patient would have to file the claim?
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