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Lawyer moms, help. DF went through IVF in summer after being repeatedly told that her insurance covered unlimited # of IVFs, was unsuccessful, had no insurance issues, and unsuccessfully went through another cycle again in Dec. Now doc called her to say that his staff made a mistake and insurance does not cover treatment. Insurance told her they made a mistake paying for 1st cycle. She has no money and would never do 2nd cycle if knew it was not covered. Is she responsible for payments? Does doc assume any responsibility for misinforming her? How to best proceed?
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the doctor has NO responsibility here. Insurance is between the patient and the insurance company. But she has a good argument with the insurance company because they paid the first time. She will need to pay the doctor and then fight it out with the insurance company.
[ Reply | Options ]Once I had a similar issue with a doctor's office, but it did not involve that much money. My doctor was listed in the health insurances manual and the doctor's secretary confirmed, that the doctor was in my health insurance's network indeed. After several months the health insurance and the doctor said that they were wrong and I had to pay out of pocket. I wrote some letters to the doctor's billing office and they finally gave up demanding money from me.
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