Dr. bill in Excess of reasonable & customary

My 4 yr. old son went to an ER on 5/3/07.He needed stitches to his face
and
the ER doc agreed that she would have used a plastic surgeon. The
Plastic
Surgeon took 2.5 hours to get there and I was told I had to sign a
consent
form and agree to his billings otherwise they would not treat. I asked
how
much and was told it would be handled via insurance and they never told
me
cost although I asked. The hospital was in my PPO plan.I asked about one in my plan and was
told they don\'t look that up and just call the on call dr.Now I find
that the surgeon was not in my plan and is billing me well in excess of
reasonable and customary.They never sent me a bill & only went to my
insurance company. Blue Cross pd me based on reasonable and customary
which I paid them.The PS office never called me when that night the sutures
came out and never called when I called about billing either.They sent my
bill direct to a lawyer who is now threatening me with legal action.My son
has a noticable scar as the dr never saw him and only gave him 2 stitches
that dissolved overnight.Lawyer told me that I was liable for theft of
services by cashing insurance checks although they never billed me which they are now
not disagreeing with.Lawyer told me that if I didn\'t pay in full they
were filing against me on 11/19 when the first bill i got was from them on
11/15.After sending them a letter with insurance pmt. the head lawyer
called saying they wouldn\'t file yet but, wanted payment in full.I am trying
to file an insurance appeal but how can they just charge me arbitrary
amounts without letting me know in advance costs which are well in excess of reasonable and customary?I also think he charged me for services that
were not correct as it was less than a 1.25cm cut and he billed for up to
1/2 inch and only gave him 2 stitches and charged over $4,200 plus I paid for the ER dr and ER hospital visit. I also think dr.
office was negligent in not seeing or calling me after the surgery.
Also I feel the lawyers office and Dr. violated FDCPA by threatening me with a lawsuit and trying to tell me that I violated the law by cashing the checks shich Blue Cross told me to cash.
Am I liable as the dr office did go to my insurance company for payment and not me and charged me excessively and now are sending me to collections when they never even invoiced me?

Based on what you say here, you could file suit against them (or at least threaten to do so) in small claims court or in regular court; filing in small claims court is easier and requires no attorney...you could try to collect all of the costs and damages that you suffered due to their behavior... You may also report them to your state attorney general's office. You may have to argue they misled you and caused this bill that you would not otherwise have allowed to occur.

[lindsayp]

First of all, if the dr. lied on the explaintion of benefits, that is a crime, he can get in big trouble for that. you should get all your related paper work together and perpare to sue him. However, he can bill you when the charges the charges exceed reasonable and customary. Reasonable and customary fees are only what the insurance company will pay. I would get it together and really figure out if you are in the right. Read the fine print on everything. I took a Medical billing class, and you would be suprised who is responsable for what.