What to Do When Your Urologist Turns Out to Be a Fraud?
Hey everyone,
I recently had my first experience with a kidney stone, which was confirmed at the ER. After spending $2,800 out of pocket, I was advised to consult a urologist.
Unfortunately, the urologist recommended by the ER was unavailable for a month. I then tried two other urologists, one suggested by a family member and another by my primary care physician, but they were also booked for a month.
As my symptoms worsened, I found myself back at the ER, which ended up costing me $1,800 since I had met my deductible.
In search of a quicker solution, I turned to ZocDoc to find a urologist and found one who could see me the very next day. During my visit, I provided a urine sample and scheduled two surgeries.
I double-checked to ensure there were no prior authorizations needed before proceeding.
Soon after, I received an explanation of benefits (EOB) statement indicating another $1,800 charge for a DNA test that I never underwent and which seemed medically unnecessary.
To my shock, it appears this urologist is a complete fraud. I’ve learned that even the Department of HHS has issued warnings about him, yet my insurance still lists him as in-network.
Link to the Department of HHS bulletin
Now I’m left feeling anxious not only about the care I received but also about the financial burden I’m facing.
Is there any hope for me in this situation?
I’m really sorry to hear about your experience—it sounds incredibly stressful and frustrating. Here are some steps you can take to address the situation:
Document Everything: Keep a detailed record of all interactions you had with the urologist’s office, including appointment dates, procedures, bills, and EOBs. This documentation will be important if you need to escalate the situation.
Contact Your Insurance Company: Report the situation to your insurance company immediately. Explain what happened, provide them with the documentation, and ask about your options. They may be able to help you dispute the charges or take action against the provider.
File a Complaint: Since you found out that the urologist is under investigation, consider filing a complaint with your state medical board or the Department of Health and Human Services. This can help prevent others from going through a similar experience.
Check for Financial Assistance: Some hospitals and medical institutions have financial assistance programs. Depending on your situation, they may be able to help alleviate some of the costs.
Get a Second Opinion: It’s important for your health and peace of mind. Find another urologist who can evaluate your situation and confirm that any necessary procedures were done correctly.
Consult a Legal Professional: If you feel that the financial or medical consequences of this situation warrant it, consider consulting a lawyer who specializes in medical malpractice or healthcare fraud. They can provide specific advice based on your case.
Support Groups: Look for online forums or local support groups where you can connect with others who might have gone through similar experiences. Sharing your story may ease some of the emotional burden.
Remember, you’re not alone in this, and it’s essential to advocate for your health and well-being. Good luck, and I hope you find a resolution soon.