Is a doctors office legally responsible for informing a patient of insurance coverage before a procedure?

Question: I had a procedure done last month. My doctors office was to verify coverage before the procedure was done. They called to inform me coverage was verified and schedualed an appt. Then turned around and billed me for it. Maybe I was wrong to assume that the procedure would be covered, but I feel they owe some sort of duty to inform me if it is not. What if it would have been like $20,000, would they tell me then? If anyone can answer this for me I would really appreciate it.

Answers:
I don't think there is a legal obligation for a doctors office to inform you of your isurance coverage(or any other kind of coverage), but it doesn't make sense for them to not. If you need medical insurance it's because you cannot afford the full price of the procedure. And besides, it is just bad business on the part of the medical office because by not telling you that you are not covered, they are risking you not being able to pay.

Other Answers:
It all depends on how the doctor's office classified the procedure and how much your deductible was. If it was classified as any form of surgery, it probably went against your deductible and if you had not met your deductible, it probably didn't pay anything. THe only thing that might be of help is that the insurance co. has a contract with providers so your provider probably had to reduce the charge before they billed you for it.

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No. It is the patients responsibility to check. There is a number on your card. Always call, get the persons name you talk to, date and time. The insurance people never give thier last name, but usually they will give you the intial. Most doctors office will check for you. Whomever did your procedure, call and ask to speak to the billing department. They will help you. Otherwise chalk it up to a life lesson. Best of luck.

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