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TJ, Esq.
TJ, Esq., Attorney
Category: Legal
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Experience:  JD, MBA
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My doctors office is not giving me my money

Customer Question

My doctors office is not giving me my money
Submitted: 6 months ago.
Category: Legal
Expert:  TJ, Esq. replied 6 months ago.

Hello and thank you for the opportunity to assist you. My name is ***** ***** I'll be glad to help if I can. However, I am unclear about your question. Can you provide a little background information and perhaps clarify the question? Thank you.

Customer: replied 6 months ago.
I am covered under 2 insurances and I have been paying out of pocket for several months. I was thinking that they are not billing them correctly, but I called and everything seems to be up to date. I am sorry for the long wait time, I am an expert on here myself I am an Electrician and it kept throwing me to a page where it wanted me to answer my own question haha
Expert:  TJ, Esq. replied 6 months ago.

Hi again. No problem. Glad you responded.

However, I'm still not positive of the situation. Are you implying that you paid your doctor, and that your doctor is billing your insurance ... i.e., your doctor is being paid twice? And therefore, you would like a refund from your doctor?

Customer: replied 6 months ago.
The doctor is billing the insurance, and when they send the patients portion back they are supposed to bill it to my secondary. I am also not supposed to be paying a Co-Pay either. I got charged for 288 dollars and have the paperwork where I had paid them. I have kept paying them the co-pay and when I called to check with the insurance companies, they have where they have paid everything on file there at both insurance companies. I have called the doctors office, and they told me that they would no longer reappoint and want to cut ties completely
Expert:  TJ, Esq. replied 6 months ago.

Hi again.

So it is a situation where your doctor charged you for the same services that it was already being reimbursed for by your insurance company. In that situation, if the doctor refuses to voluntarily refund the money that you paid, you need to sue the doctor in small claims court. In order to win in small claims court, you'd need to show the judge evidence that the doctor was reimbursed by your insurance company for a specific service, and that you also paid your doctor for that same service ... i.e., show evidence that your doctor was paid twice for the same service.

Fortunately, small claims court is designed for non-attorneys, and the rules of procedure and evidence are relaxed in comparison to other courts. Most likely, your only expense should be the filing fee and service fee. In order to sue in small claim court, you should visit the local court clerk for the proper forms. Then you fill out the forms, file them with the clerk, and ask for the sheriff to serve the summons. After the defendant is served, a trial date will be scheduled.

Does that answer your question? Please let me know if you need clarification, as I am happy to continue helping you until you are satisfied.

Customer: replied 6 months ago.
I need to get all my insurance papers showing where they have paid? And then get copies where I have paid? I have been paying them 20 dollars a visit since March of 2016. Do I have the right to go get all my reciepts from them? Even if past dated?
Expert:  TJ, Esq. replied 6 months ago.

That is correct. You must show evidence of double payment, so you will need to show that the insurance paid for the same service that you paid.

You can ask for past dated receipts. But if they don't give them to you, then you can't force it unless you were to subpoena them or request them in a document production request. This is a double edge sword, however, since you can't ask for document production in small claims court. Instead, you'd have to sue in the higher court, which also means you'd need to strictly adhere to the rules of evidence and procedure ... i.e., it's not nearly as friendly for non-lawyers as small claims court.

Expert:  TJ, Esq. replied 6 months ago.

Just letting you know that I'm signing out for the evening. If you have another follow-up question, feel free to post it and I'll respond tomorrow as soon as I am able.

Thanks!

Expert:  TJ, Esq. replied 5 months ago.

Hello again. I didn't hear back from you, and you haven't yet rated me, so I'm just checking in to make sure that you don't need more help on this issue.

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