Legal Question in Consumer Law in Massachusetts

I went to an ENT surgeon in Massachusetts for a second opinion on a deviated septum diagnosis. I spent 20 minutes in the ENT's office and he inserted a rigid metal scope about one inch into my nose to examine me. No anesthetic was used and this was about as invasive as when a GP looks into your ears with the very familiar "otoscope."

My insurance company and I were billed over one thousand dollars for this office visit and then less-than 60 second scope of my nose was considered a $700 procedure. My insurance company expects me to pay about $150 of this. I certainly will pay the copay for the office visit, but the "procedure" is ridiculous and I believe I am being grossly overcharged.

Do I have any legal recourse?

Asked on 10/27/10, 3:11 pm

1 Answer from Attorneys

Donald Drouin Law Office of Donald Drouin

No, most insurance companies will tell you what is covered and your responsibility as far as payments not covered. Always ask your doctors about procedures first then call the company to see your level of coverage, then you can a more educated decision.

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Answered on 11/06/10, 4:50 am

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