Quote:
Originally Posted by Denbal82
I just went to Legacy Chirpopractic Care yesterday and I felt I got ripped off for being a new patient.
I needed to see a doctor ASAP and they had a opening opposed to the others I had called for an appointment. I did call my healthcare insurance prior to make sure Legacy Chiropractic Care was in my network - they were.
At the counter they told me I had to pay a "new Patient Fee" of $119. I thought that was ridiculous but I was in needed relief. They also told me that most insurance companies will pay for that charge. Thats BS ! as I found out later. My healthcare insurance also said "thats not right" after talking with them after my appointment. I felt they should have told me that over the phone when I made my appointment instead of putting me on the spot at the counter.
I later checked around and found out that other chiropractic care facilities do not charge a new patient fee. I felt like I got totally ripped off.
If you are a new patient, I would AVOID Legacy Chiropractic Care on Laurel Manor Dr.
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If Legacy is going to bill your insurance company for your care, they will be using standard CPT codes. There is a code for new patient visits and a code for established patient visits. The new patient code has a higher allowable and reimbursement to cover for the additional work of setting up your chart, introducing you to the office expectations etc.
When you get your EOB, explanation of benefits, for the visit, look at what code(s) were used. If a new patient code was used you were double billed and I would loudly complain to the insurance company about fraudulent coding as they have already been paid extra for your newness. I would also insist that Legacy refund your $119. You paid it with the expectation that your insurance company would refund you.
Now, I've never heard of an insurance company refunding to a patient for a covered service when the doctor participates and will be paid directly for the rest of the visit charge. If the charge were legitimate, then Legacy should include it in the claim they submit to your insurance and be paid the allowable by your insurance [after applicable copay etc] The fact that they insisted you pay and hope you'll get it back strikes me as proof they didn't expect the insurance to pay that charge.
Almost all insurance contracts with doctors include a paragraph that the patient is not responsible for non covered services unless you agree to that service. As you agreed to pay the 119 I don't think that prohibition would apply here.
Lastly, you apparently thought you had a chiropractic emergency. Was it worth 119 to get treatment? Did you get the relief you wanted?