Pennsylvania | Insurance Law
Legal Question
I saw an out-of-network (OON) doctor in Nov 09. Before making the appt I checked with Aetna about my OON benefits and they said I'd pay 30% coinsurance on the agreed-upon rate between the doctor and Aetna. I also checked with the doctor, who said he took Aetna insurance, and agreed I'd only be billed the 30% coinsurance.
I received a letter from the doctor Dec. 29th stating, "as you are well aware I've been in a long-standing dispute with Aetna...". I was not aware of this. He says that Aetna has withheld payments since April, he's tried to let it impact his patients as little as possible but he can no longer afford to do so and I need to pay my balance of $8000. This was the only sort of "bill" I got. On 1/2/10 I rec'd a letter from his attorney, saying my acct. was in default and I had to pay.
Was it illegal, or just unethical, for the doctor to not let me know about this dispute with Aetna? I would not have gone there had I known! And I don't have $8000. What do I do? Please help.
Share This On:
Legal Answer
|
Read More Answered By: Richard Teitell |
|
|
