Legal Question in Insurance Law in Texas

Hmo
I belong to an HMO. When I visit my doctor, I have a $40.00 copay, which I always pay at the time of the visit. For a short period of time I was also covered on my wifes insurance. They do not coordinate benefits with an HMO plan so we dropped the coverage. They did however, pay my deductable to the doctor, even though I had already paid it. When I requested the overpayment back from the doctor, they kept some of it to cover what the HMO did not pay. The whole point of having an HMO is the one flat rate. What can I do to get my money back?

Asked on 3/23/09, 8:15 am

James Grissom Law Office of James P. Grissom

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Re: Hmo

You could sue the dr. in small claims court for the amount retained in breach of contract. Good Luck.

Answered on 3/23/09, 9:37 am

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