Can a doctor charge for an office visit after talking to his receptionist on the telephone.?

Question: The last five times I have gone in for a scheduled appointment with my doctor he has not even shown up in the office. His receptionist (not even a nurse) takes my temperature, blood preassure, and asks why I'm there. Then she calls him on his cell phone with the information. My insurance gets billed over a hundred dollars for an office visit. When I complained to the Insurance company they told me it was between me and the doctor. Go figure.

--- yes I have already changed doctors.

Answers:
In the US, Medi-care sets the standards for billing. It is against Medi-care rules to overcode a service. For a nursing only visit with no physician visit, the doctor should be billing code 99201. With increasing problem difficulty the code goes up to 99202, 99203, 99204, 99205 and the cost of the visit goes up. In your situation, the doctor should only be billing you 99201. Each doctor and practice sets a price on each code level. For instance, we usually bill the insurance companies $45 for 99201.
In addition, any code from 99202 and 99205 requires a physical exam by the physician (no, vital sign measurements don't count).

I would report this guy to the Medical State Board. Talk to the insurance company again and see if they has a fraud division.

Don't forget that initial visits are usually more expensive that follow up visits.

If you belong to an HMO, forget about it cause no matter what you bill you only get a set amount.

Other Answers:
I would write a letter to the AMA (American Medical Association) and lodge a formal complaint. I am surprised that the insurance company doesn't see this as fraud. I'm in nursing, and this certainly should not happen EVER. No, a doctor cannot charge you for not even seeing you.

---

There are such codes as "phone consultation" codes and these are considered a type of office visit but many insurance companies do not pay for these. Call your insurance company and explain the situation, if they show that he is billing codes fraudulently (he billed saying he was present) then they will investigate his office and you may be able to get your copays back

---

---

More Questions and Answers

• What came before the HSE?
• Should I be seen by a Dr, slipped on wet mossy rocks by ocean and cut up bottoms of feet now throbbing?
• i have a pretty bad ingrown toe nail. is it safe for me to ram some scissors up the middle and cutitoutmyself?
• I was walking down the stairs, and I think I pulled something in my foot. The inside of my foot is swollen.?
• Eczema and Flaxseed Oil?
• Bang, I crushed into a car with my bike(again)?
• Why do some people only shower every 2 days?
• I am having an M.R.I. tomorrow for back pain and I am clostraphobic?