I was refused service at a pain management doctor. They said I had to pay co-insurance upfront but I have no co-pay?

UPDATED: Sep 30, 2022

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I was refused service at a pain management doctor. They said I had to pay co-insurance upfront but I have no co-pay?

They called the doctors and told them I don’t have a co-pay. Yet, they still refused without upfront payment. They renamed co-pay to co-insurance.Now they refuse to reschedule me. My employer was expecting a diagnosis. Their refusals could cost me my employment. And they’re in network.

Asked on December 5, 2016 under Insurance Law, South Carolina


SJZ, Member, New York Bar / FreeAdvice Contributing Attorney

Answered 5 years ago | Contributor

You may need to find a different doctor. You can't force a doctor to treat you if you don't pay what they want; even if turns out that that the doctor's office is wrong, there is still no way to compel them to see you (if they are wrong, you can file a complaint aganst them with the state agency that licenses and oversees doctors, or the insurer can drop them from the network, but that still doesn't get you seen). They would not be liable for any loss of employment, because that is not a "reasonably foreseeble" (normally or typically predictable) result of not having treatment--typically, your employment is not based on a diagnosis. So the best thing for you to do is to either find another doctor--or pay them what they want, get your diagnosis, then work with your insurer to try to get the money back later.

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