They have to know they have this coming after the office visit I just recently had: If you've been…read moreseen at this office, pull up your Explanation of Benefits (EOB) on your insurance app immediately. You are likely being overcharged by a staff that operates on a mix of arrogance and total ignorance of their own contracts.
I'm a skeptic by nature. I read the bad reviews and thought, "I'll be the judge of that." Convenience won, and for a minute, it seemed fine.
The doctor himself is a nice guy...accommodating and professional. He was training a female doctor during my first two visits, who, oddly, I never saw again for the remaining five appointments. The office staff was cordial and they were doing their thing back there...
But that "laid back" atmosphere eventually curdled into something toxic. By the fourth visit, the vibe was off...Whispering behind the counter, giggling at weird times, and a robotic, emotionless "deadpan" manner from the staff. Just an uncomfortable, toxic-adjacent environment.
What became interesting was how every visit, they demanded a $50 specialist copay. I thought this was okay because my insurance card says specialist would cost as much. However, when I finally checked my EOBs, Blue Care Network had listed my responsibility as $25.00 per visit, with the fine print explicitly stating: "Your provider should not ask you to pay any more than this amount." When I brought this documented fact to the office manager, I was dismissed. A male employee behind the counter who was entirely irrelevant to the conversation decided to rudely insert himself just to be condescending. It's always the ig talking to you as if you're the ig one.
I went home, did the research, called BCN, and confirmed I was 100% correct. The EOB is the single source of truth. If BCN processes a claim at $25, the provider is contractually prohibited from charging you a penny more.
Today, at my final visit, to my surprise, they initially took the $25. But after seeing the doctor, I came out to find the office manager waiting with a smug attitude to tell me I was wrong and she had "just spoken to BCN."
When I tried to explain (for the 15th time) how medical billing codes actually work, the entire front desk lost it. All three employees started talking over me loudly. The office manager became incredibly animated, swinging her head, waving her hands and getting excited. I'll admit, the situation pushed me to a point of matching her energy, but the result was laughable: I was "discharged" (as if I was going to continue going there after this) and told by the other irrelevant girl that she was "calling the police right now!" (LOL) All because I insisted they follow their own insurance contract.
Yeah these people are aching for conflict. It's a bizarre sight to see adults have a collective meltdown because a patient understands their billing better than they do. Ignorance isn't an excuse when you're dealing with people's hard-earned money.
Check your EOBs. You probably have money sitting in Gammons' bank account that belongs in yours
In the meantime I suggest that the office manager and her supporting staff educate themselves by cracking a book on basic medical billing. Oh, and to the office manager: charging more than the member responsibility listed on the EOB is a contractual violation and, in some cases, can be reported as insurance fraud.