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Law Educator, Esq.
Law Educator, Esq., Attorney
Category: Legal
Satisfied Customers: 88753
Experience:  JA Mentor -Attorney Labor/employment, corporate, sports law, admiralty/maritime and civil rights law
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Knee surgery patient being charged for a physician who was

Customer Question

Knee surgery patient being charged for a physician who was not in the insurance system until approx 3 weeks after surgery. Insurance will not pay this $10,000+ fee for the physician. How can patient be responsible when it was the hospitals oversight? This physician was simply an extra person in the OR and not on the surgical team. Thank you. Karen in Illinois
Submitted: 1 year ago.
Category: Legal
Expert:  Law Educator, Esq. replied 1 year ago.
Thank you for your question. I look forward to working with you to provide you the information you are seeking.

If you did not contract with this doctor and he was merely in the room as an extra and not part of the surgical team, you have grounds to dispute the fee with the hospital and you can also seek to file suit against them for breach of contract for them charging you improperly for someone who provided no services and was not part of your team. You would start by filing a written demand to the billing department that they remove the charge for services never provided. If they refuse to do so, then you can seek to file suit against them for unfair and deceptive practices and improper billing for charging you for services you never contracted for and for a doctor who was not part of your surgical team and was merely an extra.

This is your legal remedy against the hospital improperly billing you for services not provided to you.



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Law Educator, Esq., Attorney
Category: Legal
Satisfied Customers: 88753
Experience: JA Mentor -Attorney Labor/employment, corporate, sports law, admiralty/maritime and civil rights law
Law Educator, Esq. and 8 other Legal Specialists are ready to help you
Customer: replied 1 year ago.
Thank you ~ appears a lawsuit is in order
Expert:  Law Educator, Esq. replied 1 year ago.
Thank you for your response. Yes, if you cannot negotiate this with the billing department first, you would have to sue them for their improper billing practices.

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