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Law Educator, Esq.
Law Educator, Esq., Attorney
Category: Legal
Satisfied Customers: 111550
Experience:  JA Mentor -Attorney Labor/employment, corporate, sports law, admiralty/maritime and civil rights law
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I went to my appt with my GP..arrived at 11:15 11:30

Customer Question

I went to my appt with my GP..arrived at 11:15 for an 11:30 appt. (left office at 1:00)
I had a rash in my groin area. The doctor came in...I stood up...took off my jeans and raised my underwear. He NEVER touched me...gave me his answer and called in medicine.
I received the bill.....charges: Initial AWV (Medicare)....$162.18........Office Visit, Est Pt., Level 4....101.24.
BCBS of Oklahoma PPO pmt.....$0.00. Charging me to pay the $101.24.
I was there almost 3 hours...did not get on his table...never undressed with the exception of taking off my jeans.
I feel like this is wrong. I usually go to Urgent Care...get in in 15 minutes...see a doctor and leave. My ins. or medicare has always paid.
I have informed their office...twice...and their billing office twice..that I am protesting this service. I am a 76 ear old retired Business Owner...in good health and mind. Please advise.
Submitted: 8 months ago.
Category: Legal
Customer: replied 8 months ago.
MEDICARE NOVITAS SOLUTIONS PAYMENT WAS $158.25...that left my balance owing $101.07
Expert:  Law Educator, Esq. replied 8 months ago.
Thank you for your question. I look forward to working with you to provide you the information you are seeking for educational purposes only.
I am afraid that while it may seem to you as though no service was provided, what you describe is the norm in medical care more often now than not and it is perfectly legal for a doctor to bill patients for this type of care. Your visit should be still covered by medicare and BCBS as a supplemental provider and you should still submit your claim again to BCBS to get them to pay and if they refuse, then you need to file a written appeal if this type of office visit is covered under your plan with them and provide them proof BCBS paid their share. However, legally, even if the doctor came into the exam room and only spoke to you about your condition and never touched you or examined you, they can still legally bill since you did take up their time and came into the office for the visit.