I would refuse to see the patient. As far as I am concerned, refusing to pay or even discuss the bill is being "dissed." (BTW, did you resubmit the bill in about a month? The insurance companies around here routinely take 6 weeks to put the kid "on the contract." We resubmit that kind of bill after an appropriate interval.) The doctor-patient relationship has to have mutual respect and trust. I do not want patients who neither trust or respect me. ------------------ Reply Separator -------------------- Originally From: Michael Sachs <> Subject: Old Balance Still Due Date: 08/03/1999 01:10pm What would you do with this situation: I saw a new patient for the first (and only time) when she was two weeks old approximately two years ago. Her mother presented a PPO insurance card and paid the specified co-payment at the time of the visit. When we billed the PPO (which I am part of) the claim was denied as "child not covered." The balance remaining was $50.00. Monthly statements and eventual phone calls were ignored and the account was sent to collections and still remains unpaid. Because there had only been one visit and so much time had passed, a formal letter dismissing the patient from the practice was never sent. Yesterday the mother called, said the child was covered under this PPO now and she wanted a same-day appointment. I told my front office staff to tell her we would see the child but she would need to pay the old balance as well as the full payment for a same day visit (or the same day co-pay if we could verify at the time of the appointment that the insurance did indeed cover the child at this time). She was also told she could see the same provider who has been caring for the child for the last two years if she needed to. She apparently became belligerent, made statements like "So Dr. Sachs is REFUSING to see my child who is covered under this plan which he is part of", and finally shouted an expletive and hung up. I have on occasion seen patients under these circumstances and almost invariably the account winds up with a larger outstanding balance (which also is never paid) then before I accepted the patient back. So what would you do? See the patient unconditionally? See the patient, require payment for the same day visit but leave the old balance outstanding? See the patient and require full payment for everything? Refuse to see the patient at all? When you do see patients under these conditions would you accept a personal check? And legally, does anyone think this could be considered patient "abandonment". I certainly didn't think so, especially since there are dozens of pediatricians on this health plan within a five mile radius and I wouldn't consider a single visit two years previously as having established a doctor-patient relationship. Looking forward to any response. Michael Sachs, M.D. General Pediatrician ---------------------------------------------------------------------- - group. "http://www.pcc.com/lists/";