Doctor billing question - Scam??

[masraum]

Someone that I know scheduled an appt to go see a Dr for a cosmetic consultation. When the appt was made, no mention was made of a consultation fee/charge. Four other Drs were seen for the same consultation, two did not charge, and two advised when the appt was made that they would be charging a consultation fee (which seems fair and is not a problem). While seeing the Dr, the Dr said "I think you have medical problem X." (somewhat related to the consultation). About 3/4 of the way through the consultation, the Dr asked "do you have insurance" and then said "ok, we'll charge your insurance."

There's now a bill. The office was asked what the consultation fee is, and it's normally $100. What the person's insurance was charged was over $600, presumably because the Dr said "I think you have medical problem X". (The charge is for "Office Consultation co Patients Responsibility."

To me, this sounds very crooked. It sounds like the Dr and/or his office has a scam in place to increase their profits. (no tests were done, no equipment used, this was a diagnosis made based on visual inspection.) The person was told "do a search for my videos on youtube about this subject.

Does this seem like a scam?

What is the best course of action to tell the Dr to piss off on the amount that the person's insurance didn't pay and is there a good reason to try to get the portion that the insurance paid refunded?

The person is happy to pay a reasonable amount for a consultation, but this seems too much and like a scam.

[Baz]

What the person's insurance was charged was over $600,

Just based on what you posted (see above quote in particular) Steve - I would think it's the insurance company's responsibility to figure all this stuff out so everything is in proper order, more or less.

[masraum]

Originally Posted by Baz

Just based on what you posted (see above quote in particular) Steve - I would think it's the insurance company's responsibility to figure all this stuff out so everything is in proper order, more or less.

The ins co covered $400, the individual is now being chased for the extra $200.

[wdfifteen]

Originally Posted by masraum

The person was told "do a search for my videos on youtube about this subject.

Does this seem like a scam?

Yes. The doctors I trust don't make promotion videos for Youtube.

[masraum]

Originally Posted by wdfifteen

Yes. The doctors I trust don't make promotion videos for Youtube.

hahahaha

[Tobra]

Pretty sketchy, but probably not illegal.

[masraum]

Originally Posted by Tobra

Pretty sketchy, but probably not illegal.

Right, I didn't think it was illegal, but it sounds like something one of "those" used car dealers would do, kind of like a bait and switch.

[LWJ]

If a business has a contractual representation on a Youtube video, I would not think that this is a binding contract.

I am NOT a lawyer and I didn't go to law school. Just my $.02.

[asphaltgambler]

Had a local Dentist that I knew very well. I was his patient for over 20 years and I knew him outside of his practice. I loved the guy as he was very good at his craft and we even traded work one time where I needed a lot done and his daughter's car needed a lot of maintenance work - even up.

Unfortunately he had cancer and got to the point of having to sell his business and told me he searched very carefully to pick the right guy / team to take over. Once they were in there - game over. Like taking your car to qwik lube place for just an oil change. You know what happens next. They pulled every trick to upsell, overinflate co-pays, X-rays every time I visited, etc.

FYI, my wife is in the business - so I know how things work at least in that field. which after the 5th or 6th 'hustle' ............I mean visit..........I called them on it. Turns out the co-pay was inflated by @$60.00 or so. When I asked for a refund (later) took them 3 months of stalling and excuses.

Illegal?..........no. Shady as s**t? of course.

[masraum]

That's how this sounds to me.

[masraum]

In case anyone was curious, the Dr office called the person back, and supposedly refunded the insurance and instead is going to charge the person that came in their consultation fee (which is apparently $125-165, so they are, of course, going with the $165). Still, I'd consider that good news.

[T77911S]

I broke 2 bones in my shoulder many years ago in a mountain bike wreck.
the doctor did not touch/set either bone. I/insurance was charged for "2 broken bones"
yes there was a price per bone.