Is this a Tactic for my Provider to Avoid Reimbursing for Fees That Were Collected on 2x??

I made a post last month about this issue but… is this common?? I paid out of pocket for services my insurer paid for later (In Network provider, met OOP Max, they paid 100% of allowable rate). When I first mentioned the issue the office was weird about it… “the billing department is on a call with another patient… can they call you back?” (would never call back), I would wait a week call/email or leave a voicemail and then follow up a bit later. I waited more than sufficient time in between each point of contact because I get it, I’m not the only patient. But anyway, I continued to get weird responses “sorry, I was out of office and will look into this…”, “sorry, there was a death in the family and I’ve been out of office” (for a month? but okay…), “hi! Still working on this…”, etc.

After probably a year of this I just got tired of the runaround and tried to contact my insurer(Aetna) to deal with it.

Now they completely will not speak to me or respond to emails/texts (I actually had the dentists phone number and he ALWAYS responded pretty quickly). That’s fine… but they also won’t speak to Aetna customer service reps either?? Aetna is working on it… I believe they said they were cutting off any incoming payments until the office reached out (money talks and Aetna is a HUGE account). They have not dismissed me as a patient or anything (though I will no longer be returning).

What is the tactic or reasoning here? Had they just gave me the money when I asked for it (I was always polite and reasonable with my timing) it seems like it would’ve caused far less of a headache for everybody… now Aetna has advised me to report them for fraud, report them to the state, etc…

See also  Cigna provided very wrong estimate, says they would review, but never did. Caused me to miss discount rate on original bill. How to navigate?