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» LymeNet Flash » Questions and Discussion » General Support » Dr. S in Bridgeport (CT) Anyone in trouble with insurance?

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Author Topic: Dr. S in Bridgeport (CT) Anyone in trouble with insurance?
christelleny
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Since Dr. S opened his own practice in Bridgeport, my insurance (Aetna) has denied all my out-of-network claims.

I had no problem when he shared a practice in Westport.

They claim his tax ID is not a valid tax ID.

He insists the tax ID is valid.

I'm wondering if anybody has the same problem.

Posts: 159 | From CT, USA | Registered: Jan 2005  |  IP: Logged | Report this post to a Moderator
lou
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Could it just be a sneaky trick on the part of the ins co?

I wonder if the doc would have in his files a letter from the state or whoever issues the tax IDs. Maybe if you sent the ins co a copy of this letter? Registered mail, with a copy for your own files in case they are being tricky.

Posts: 8430 | From Not available | Registered: Oct 2000  |  IP: Logged | Report this post to a Moderator
christelleny
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I'm usually the first one to suspect foul play from the insurance company.

However, in this case, they've asked him several time for a W-9 form (whatever that is) and he hasn't provided them with the info.

I trust him 100% as my LLMD, but I'm begining to wonder if *maybe* he's not registered to practice in CT (hence him sharing a practice and using the practice tax ID before).

God, I hope not.

Out-of-network benefits are far better than big nothing.

Posts: 159 | From CT, USA | Registered: Jan 2005  |  IP: Logged | Report this post to a Moderator
break the chains
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this guy is not too bright. he has said some of the most ridiculous things to me. things that are absolutely not true. once he said that since i had been on iv for 3 months there was no possible way i could still have any kind of lyme disease, mycoplasma, or coinf and that the problem was something else. he explained that it was my fault and i just needed to get better. he also has no understanding of how these abx work. the last time i saw him he would flat out ignore some of my more technical questions, or he would make something up which was absolutely wrong. good luck with this guy... i guess i would give him a shot, but if its not working out dont waste too much time with him.

[ 04. March 2006, 01:05 AM: Message edited by: break the chains ]

Posts: 245 | From connecticut, the lyme state | Registered: May 2004  |  IP: Logged | Report this post to a Moderator
DeLo5
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Hi

My teen age son has chronic lyme. He just started going to Dr. S. in Bpt (to treat Scarlet Fever). Has anyone been to see Dr. S. long term and how are your results?

It's concerning about the insurance. He is expensive, but he does give you soooo much of his time in return, which I appreciate. Finally someone to listen to the myriad of symptoms over the years!

Any input would be appreciated.

Posts: 35 | From Litchfield County | Registered: Mar 2006  |  IP: Logged | Report this post to a Moderator
mlkeen
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I had a similar problem with a practice in Pa. I had gone to the same place for years, but to a new doc. His number wasn't valid. THe billing dept had to use they number for the practice to get my insurance to pay.

Of course the insurance company didn't tell me this was the problem, just denied the claim and I don't remember how I found out what went wrong.

I imagine soneone doesn't have the right numbers in the right place- but you already know that!

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christelleny
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quote:
Originally posted by break the chains:
this guy is not too bright. he has said some of the most ridiculous things to me. things that are absolutely not true. once he said that since i had been on iv for 3 months there was no possible way i could still have any kind of lyme disease, mycoplasma, or coinf and that the problem was something else. he explained that it was my fault and i just needed to get better. he also has no understanding of how these abx work. the last time i saw him he would flat out ignore some of my more technical questions, or he would make something up which was absolutely wrong. good luck with this guy... i guess i would give him a shot, but if its not working out dont waste too much time with him.

We cannot possibly be speaking of the same Dr. S.
Posts: 159 | From CT, USA | Registered: Jan 2005  |  IP: Logged | Report this post to a Moderator
DeLo5
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Hi Christelle,

Just wanted to let you know I called my insurance company regarding sending them Dr. S's superbill for payment. They said that he was not in their system, yet. They told me to provide them with (or Dr. S. could provide them with) his name, address, tel #, tax ID, and license # SO THEY CAN PUT HIM IN THEIR SYSTEM.

She said that's all that needs to be done and then they'd process my superbills for payment. Someone in your insurance company office doesn't understand that just because a doctor isn't in their system, he still does exist!

Let me know if you have any more problems/questions regarding this.

I have decided to definitely pursue treatment for my son with Dr. S.

Blessings,
Judy

Posts: 35 | From Litchfield County | Registered: Mar 2006  |  IP: Logged | Report this post to a Moderator
   

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