OT - unethical ploy by business to steal money

You're right, it's a scam. Don't pay it.

never get a quote from a doctor, ALWAYS get the price directly from your insurance provider.

i had a similar situation where i paid at the dr's office and then 2 weeks later i got a bill for 700 dollars. my situation more involved my insurance, so i solved the problem through them. you should go in person to the doctor with all the information and ask them to explain. if it seems like it isnt right then go get a lawyer. no reason to yell or scream at a secretary on the phone, just go in and talk to them. if they wont budge, get a lawyer immediately so that you can be a step ahead of a credit situation.

any others run into problems like this?

Unfortunately no - YOU are obligated to contact the insurance company. Health insurance companies are out to screw you more than any other business.

Insurance is a contract between you and the insurance company. The doctor has no legal requirements to be accurate with his estimate about what your insurance will cover. This is why it's called an estimate, it is only an estimation of coverage. If for some reason the insurance company has chosen to deny you, it is in no part the doctor's responsibility to persue collecting from them.

Remember, insurance companies make money by not paying claims.

the insurance company didn't deny the claim. they paid what is considered reasonable for the area, which was several hundred dollars. i also paid $50 and $123. the doctors office, i believe, decided to charge a higher rate than what an in-network cost would be after the fact. i believe they are doing this unethically since they had asked me beforehand what my insurance company was, called me back afterward and said the consultation would be $50 out of pocket. that is when i agreed to the consultation. they also said the surgery would be $123 which is what i agreed to as well. i went in a week later for the surgery and paid $123 upon leaving. a month goes by and they say they are billing more since i am out of network. this does not seem right.

Before getting a lawyer talk to your insurance company. The doctor is simply billing you for whatever costs the insurance didn't pay.

It sounds like you had an office copay, and then a co-insurance (a percentage of the costs) that you paid. You need to look at your EOB (explanation of benefits) from your insurance company to see what the additional cost was. It was probably related to the fact you went to an out of network Dr. But this could have been brought up BEFORE the surgery.

I don't think there was anything unethical going on here. Medical / Dental insurance is complicated (overly) and it is easy to screw up a claim. My advice is to call your insurance and simply ask for an explanation of the charges. There is an appeal process if you need to go that route. This process should be explained in your EOB. If you still think you are being screwed try contacting your state insurance department, and see what they can offer.

Good Luck with that.

thanks to everyone that responded.

update. the doctor's office left me a message on my house phone yesterday to call them back. i called them back this morning and they said the office has written the expense off and i owe nothing. their excuse for overbilling was that the receptionist somehow thought i was in-network and so i was told the in-network costs. how they make this kind of mistake i'm not exactly sure (i don't preclude the possibility that they are attempting to operate within the "gray area" of business). i am happy that there will be no additional payments to make however.

you are lucky. I am still getting bills for 800 bucks for the part that they said the insurance would cover, but the insurance is NOT