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Question

My sister is being denied health care. She has always had insurance. She scheduled an appointment with her GYN doc and two weeks later went to the appointment. She was billed over $500 for the visit and an ultrasound of her ovary. After the appointment she found out that her GYN stopped taking her insurance. The GYN office failed to notify her that all her expenses would be out of pocket. My sister would have never kept that appt. My sister has slowly, faithfully been paying off this bill; she still owes over $200. Recently, my sister had a massive nasal hemmorrage; she was instructed to follow up with the local ENT doc. The local ENT docs refused to see her until she pays the GYN bill in full. My sister has never gone to any ENT docs in her life. Did the GYN docs violate her hipa rights by sharing info? The GYN and the ENT docs are currently contracted under her insurance to provide her care, shouldn't they honor their contract? Should my sister have to pay the GYN bill in full?

Submitted: 383 days and 21 hours ago.
Category: Legal
Value: $30
Status: CLOSED
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Sandusky, Ohio

Already Tried:
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Accepted Answer

Just because her doctor stopped taking her insurance, does not mean that she should not have still filed the claim with her insurance on her own and if it has been less than a year ago, they should still take that claim. HIPAA does not prevent healthcare providers from sharing non-medical information about patients, so there are no violations under HIPAA. She should contact her insurer and inform them of what is happening and she is being forced to pay because the GYN is not accepting their insurance, and if he is under contract with the insurer, they will handle and work with her to get her money back. Unfortunately, a patient is obligated to pay the bill of the healthcare provider, but should not be denied care of other providers until that bill is paid. She could consider a lawsuit against the GYN for "torious interference with contractual relations" since the GYN is interferring with her ability to contract with the ENT.


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Expert: PaulMJD
Pos. Feedback: 99.5 %
Accepts: 
Answered: 11/4/2008

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