Q: I received a surprise invoice from a pathologist after a procedure at the dentist. Is there any way I can dispute?
I had a procedure done at the dentist. I asked several times what the full amount of costs would be ($900 all in!). They wanted my health insurance ID. I asked why, they said it's for the pathologist but it will be covered by insurance: no problems there. I confirmed this twice since I have an HMO and wanted to know whether I needed a referral. I was ensured that I didn't. Now - after the procedure - I receive a $540 invoice from the pathologist (which I never ever had contact with, nor did I provide them with my info). I contacted the dentist and they say they can't do anything about it. I am not willing to pay the invoice since I wasn't give a choice (to send tissue to the pathologist or to postpone the procedure) or a price beforehand. The procedure already costs me $900 out of pocket (which I was aware of beforehand) and $540 was just added without me knowing. Can you advice? Thank you.
A:
An Illinois attorney would need to advise, since insurance practices are governed by state law. But your post remains open for three weeks. One option, before seeking meaningful input from a local attorney in the Chicago area could be to explore what the carrier could do. With surprise invoices, carrier examiners see them with more regularity nowadays, and sometimes they are able to advise or review the claim. There's no guarantees there - it could depend on the carrier, the policy, the services, the basis for the surprise invoice, and experience of the claim examiner. Good luck
Tim Akpinar
Justia Ask a Lawyer is a forum for consumers to get answers to basic legal questions. Any information sent through Justia Ask a Lawyer is not secure and is done so on a non-confidential basis only.
The use of this website to ask questions or receive answers does not create an attorney–client relationship between you and Justia, or between you and any attorney who receives your information or responds to your questions, nor is it intended to create such a relationship. Additionally, no responses on this forum constitute legal advice, which must be tailored to the specific circumstances of each case. You should not act upon information provided in Justia Ask a Lawyer without seeking professional counsel from an attorney admitted or authorized to practice in your jurisdiction. Justia assumes no responsibility to any person who relies on information contained on or received through this site and disclaims all liability in respect to such information.
Justia cannot guarantee that the information on this website (including any legal information provided by an attorney through this service) is accurate, complete, or up-to-date. While we intend to make every attempt to keep the information on this site current, the owners of and contributors to this site make no claims, promises or guarantees about the accuracy, completeness or adequacy of the information contained in or linked to from this site.
