Maryland  |  Consumer Law

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5/26/07, 11:41 pm

Legal Question


Medical Billing Dispute

My insurance company did not cover a medical visit; I paid the same fee that the insurance company had negotiated with that provider.

The provider says I am responsible for the undiscounted fee (2X as much). I am arguing that I never agreed to pay whatever they want -- just a resonable fee for service. I maintain the fee the doctor negotiated with the insurance company is a reasonable fee.

There is no written agreement between me and the doctor on the dollar amount of the fee. If I had known that both the visit would be uncovered and that the doctor would insist on charging me twice what he accepts from insured patients, I would have taken my business elsewhere.

If this went to court, would I win given that there is no written agreement (nor clear disclosure prior to the visit) of what the fee would be. I feel like I am getting gouged.


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