Patient First

My son had cut his finger and needed stitches. I have been hearing a lot of advertising regarding Patient first in our area and I thought I would try it instead of sitting in an Emergency Room for hours. I am educated in insurance and I asked point blank. Do you accept my insurance? And how will this be billed to my insurance? Office visit or emergency room? He assured me it would be a office visit and that the follow up visit to remove the stitches would be covered under the first office visit… I paid my specialist office visit co-pay. Then the bills starting coming.My insurance company never received the claim… It took two sets of phone calls with Patient first and Blue Cross/Blue Shield to get this resolved… This was a patient first issue. The first time I called they told me oh well we tried billing them its on you. Once that was finally resolved I started getting late payment notices for the difference of an office visit and an emergency room visit. I called patientfirst and after several attempts to get a person to talk to me I was told that in Pennsylvania they are not allowed to bill the visit as a doctor’s visit and not only was a receiving one bill I received two. One for the original visit and one for the removal of the stitches. Information that I asked and was given misinformation when I was in the location. I asked to appeal the decision and they said okay but it is not going to get turned over. After 3 weeks I received the notice that they are not over turning the decision. I understand that the location was fairly new but if the rule in PA was different than the staff should have been trained. Also because of the lack of knowledge of their staff they should have waived the difference of what I was being billed because it is the right thing to do. So now I struggled with next steps because I don’t want to have them turn the account to collections and I ended up paying the bills. I am furious and feel that their billing practices are misleading and suspect of fraud. The medical care my son received was fine and I had originally recommended their services to friends and how easy it was. Now I take that back because they are running a scam in their billing practices.