Back in 2014, my wife went to a gynecologist affiliated with Wake Forest Baptist Hospital and this was the first year of the affordable care act. My wife, being a former health insurance agent brought it her coding sheet and specifically directed her doctor to only perform procedures/tests that are covered 100% by insurance under the ACA. A couple of months later she received a bill for $1k. Their defense is basically, the doctor deemed procedures/tests medically necessary and the doctor's opinion trumps patient instructions. Also, to add insult to injury, our insurance company said they coded the procedures incorrectly resulting in a higher charge to us. Wake Forest refuses to acknowledge the error or issue or fix it. Its been well over a year and now they refuse to even answer her phone calls. Is there a legal remedy to this? I know its one of those situation where its only $1k, but $1k is a lot to us, and also we've been defrauded. This has also gone to collections and is on her credit report. Would this be a small claims issue? Is there any potential damages beyond the $1k? Thanks
Not a malpractice issue but you may be able to resolve this by negotiating the amount with the Hospital.
Contact the hospital and offer a lower settlement. Also place a letter of explanation into your credit report file or dispute the charge outright with the credit bureau.
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