2 Office Locatins Previously Billed Under 1 Tax ID - But No Longer

I'm a returning patient of a specialist who has 2 offices in 2 different cities. When I began my treatment with this doctor in 2007, I was told by his office that my insurance, Blue Cross Anthem, doesn't cover visits in his 2nd office, only the 1st.

For 2 yrs the doctor still had me come into this 2nd office on occasion but just had his billing dept submit the insurance claim under the Tax ID of the 1st office so it would be covered.

2 yrs passed since I'd been to his office & in Feb 2011 I went for an urgent same-day visit (possible fracture). I was told he was only available at his 2nd office that day. I went there, he did an x-ray (10 min max visit), & then got hit with a $680 bill because my insurance didn't cover it.

When I talked to the person in charge of billing I learned that she wasn't around during the years I was previously treated by the specialist. She researched my previous visits to that same office & it was then that she informed me that they had been billed under the tax ID for the 1st office. She said she would talk to the specialist, & she did... however I got a reduced bill of only $547.

I finally wrote to him directly & they contacted me today to say that: 1) I could make payments on the full amount of $547 for up to 1 year, OR 2) Could pay half the amount, $273, if I paid it all at once. The woman in billing said their 2nd office has no affiliation with 1st office (even though he sees patients there once a week).

Is this fair? Can I do something about this? I feel totally ripped off & my insurance says they can only file a grievance but it won't amount to anything.

Any insight would help, as this is a time-sensitive matter.

re: 2 Office Locatins Previously Billed Under 1 Tax ID - But No Longer

My last resort before giving up would be to call the insurance commissioners office and find out if there is anything else you can do if your insurance carrier is not going to help you. You can go online for their address/phone contacts. Not sure this will help but sounds like you already tried the first two most important steps.
Since I'm not an atty I cannot give you any legal advise and this is a suggestion only. Good Luck!

re: 2 Office Locatins Previously Billed Under 1 Tax ID - But No Longer

thanks. i would hate to surrender to (what seems like) an unfair payment offer from the specialist but time is of the essence. he may very well retract his offer if i don't respond quickly. =(

i will look into the insurance commissioner idea. i don't want get anyone in trouble. i just want what's fair. ...if his offer IS fair, then i'll accept it... but i'd like to hear that from medical billing specialists (like here on this site)... not from the specialist's office who may or may not be giving me a deal, even though they say so. (thx again!)