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3 On Your Side

Annual physical uncovers big problem ... with medical bill

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(Source: 3TV) (Source: 3TV)
(3 ON YOUR SIDE) -

We all know how important annual physicals are and in many cases, they're covered 100 percent by insurance companies.  So why is a Valley man stuck with a nearly $1,200 bill? 

Aaron Rodriguez says family is important.  He does what he can to stay healthy, which includes eating right and staying active. 

"I just like to stay on top of my health," he said. "I live a healthy lifestyle. I work out, try and eat right. So, I went in for my annual physical to see my doctor."

Rodriguez says everything seemed to be fine at his wellness exam, but the doctor ordered a few additional tests. 

"'As a precaution,' in his words, 'we would like to run these tests,'" Rodriguez said.

Rodriguez says he reviewed his health insurance benefits like consumers should, and it clearly stated preventative services are covered at 100 percent -- "no charge."
   
That in mind, Rodriguez went through with those tests.

"I looked at this as totally preventative, taking a proactive step in my health," he said.  "I know doctors like that; insurance companies like that to make sure you're healthy, so I thought I was doing the right thing.”

A month later, however, Rodriguez received a bill for nearly $1,200.
   
Understandably shocked, he immediately he called his insurance company. 

"They said it was coded as diagnostic instead of preventative," he explained. 

That's a problem because if tests are not considered preventative, consumers are usually stuck with a larger part of the bill. 
   
Rodriguez called his doctor's office to request the bill be re-coded and resubmitted as preventative.
   
It's a request all consumers should make if they find themselves in a similar situation. 

"In her words, too, she was shocked I was getting this as well," Rodriguez said. "She said, 'Let me look into this. I promise I'll talk to the physician himself. We'll see if we can re-code it."

That "we'll see" turned to a "quick no."

"She called back the next day and said 'no go' so I was stuck with the bill," Rodriguez said.

Frustrated with this so-called "coding conflict" and out of options, Rodriguez contacted 3 On Your Side.

"I've watched 3 On Your Side before. I know you can get things done," he said. "I figured hopefully if I put some power behind me that maybe they'll open their eyes and get this situated, the way it should have been handled." 

3 On Your Side contacted Dignity Health, the parent company that runs Rodriguez's doctor's office.
    
Due to privacy matters they couldn't discuss details with us, but they immediately looked into his problem. Rodriguez said the doctor's office will be re-submitting his bill with the proper preventive coding.
   
That means Rodriguez should not be responsible for that $1,200 bill, and he says he couldn’t feel any more relieved.

Because the bill has been re-coded and re-submitted, this issue should be resolved.
   
But if it's not, 3 On Your Side will follow up.

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