r/HealthInsurance • u/JulesSherlock • 8d ago

Medicare/Medicaid Anesthesiologist is billing $3700 even though insurance is telling them to stop.

My husband went to the emergency room due to food blocking esophagus. He had to have a gastroenterologist, push it on down. The anesthesiologist billed his insurance who refused it based on it being filed too late. Procedure was 3/8 and they billed 7/1. Then they billed him $3700, which is when he noticed the issue. Said insurance paid $0 and if he didn’t pay by 9/15 it would go to collections. He called his insurance (United Healthcare - Medicare) and they said they would call them the next day and have them refile it. He watched for it online and saw that it had been re-filed on 8/1 so he thought it was ok. Well, insurance denied it again. It says denied due to filing too late and do not bill member. Same as last time. So he expects to get a bill in the mail any day now.

I feel like we’re going in circles. How do we get off this ride if we do get the bill again?

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u/PresentHat6725 7d ago

Have you sent eob to dr office ?

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u/JulesSherlock 7d ago

No. I figured they received that info from the insurance company. My husband’s insurance called them in order for them to refile so they have actually spoken to each other.

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u/PresentHat6725 7d ago

That doesn’t happen all the time. It could be a glitch in the system. I used to work for a hospital in Pa.