 Does Home Insurance cover vandalaism to a car ? |
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I live in Dallas, TX.
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 Whole life or term policy?? |
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kermit | Insurance- is there anything I can do?!? |
Long story- I will appreciate if you read it-
My husband was in the hopsital last summer becuase of a mold allergy (from mold at his work). He was in for 14 days and in very serious condition. When he finally got out the insurance company said "You are 100% covered. ignore all bills you get from the hospital. All doctors at that hospital are in your network." So we did. And most everything got paid. And then collections called him at work. So he called the insurance company who called the hospital and the hospital said "oh- he had 2 patient numbers. You only paid 1. We didn't tell you there were 2 numbers for one patient, but we want our $ yesterday." So the insurance sompany called them to get the number to pay the last bill. Here's the fun part- now the insurance company is calling us and saying 1 of the 3 doctors he had in the hospital was not in network. Did the hospital ask us who we wanted for a doctor? (no) Did they have our insurance info? (yes)
Additional Details
Was he in desparate need of medical attention? (yes)
So now we are in collections for $507.00.
Even better, we are moving to San Francisco in 2 months so he can go to grad school- which means landlords will be looking up our credit file- now completely screwed! What do we do? Can we do anything?
WHY DIDN'T THEY TELL US BEFORE IT WENT INTO COLLECTIONS?!! |
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Sue
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That sounds like a workers comp claim to me. It was a work related illness. So, call his employer to make a workers comp claim. That will be paid at 100% no questions asked. If you are still having trouble, contact your state's insurance commissioner. My husband had a workers comp claim that the hospital wanted to charge him the difference of what workers comp paid & what they charged (which was above reasonable & customary). This was illegal. It was only about a $30 bill which his employer wanted to pay but since I was an insurance agent, I knew better. They threatened collections but CAN'T do it, even threatened lawyers. Well, he called the State Insurance Commissioner, ended up talking to the head of the workers comp dept & all he did was fax over a printout of the law to the hospital (actually had to do it twice since the hospital "didn't get" the first one, sure) & it was taken care of. I hope this helps & good luck to you.
Also, if this shows up on your credit, you can explain it to your potential landlord, just be honest up front. I would do it when you apply - "there may be an unpaid medical bill on our credit history that is in dispute with the insurance company & hospital". |
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Outside the box
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Why didn't you go through Worker's Comp? Call them and explain your situation and see if they will cover the uninsured portion versus submitting a claim in for the entire amount......If not let them sue you in small claims and explain the services and mistake. Happens alot of double billing, a judge will make it worth your time to go to court. |
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autumn la la la
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I would check on list of doctors that insurance hold valid, to see what associations they have to belong, once you have that list, you have more amunition to fight with. Then, I would play of the fact that you were not been informed on accessibility limitations pertaining to practictioner. Try rebuttal assessment. |
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nrving
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Unfortunately, it is your responsibility to ensure that the doctors providing treatment are "in-network". It is very common to have different doctors at the same facility providing treatment for a patient and not all of them accept your insurance. One thing to note, however, is that work related injuries are normally covered by Work-comp. You should ask your husbands employer if they have work-comp, if not your they should be liable for ALL of the medical expenses. For now, you should pay the medical expenses billed to you. Talk to the employer, if the injury was work related they are responsible. |
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Get Smartâ„¢
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Wow, that's horrible. I'm afraid I won't be of much help. I know that as part of a PPO I got to choose my doctor as long as he was in the network. Outside of the network would obviously incur additional fees. I'm not sure what a patient number is or why he needed 2..!?
It sounds like his company should be paying for it. Have you talked to his HR dept? Find out if the company goes through a medical insurance broker, they are often very knowledgable. Maybe you can find answers on FindLaw:
http://findlaw.com/
Have you checked your network directory to see if the doctors he used were in it? Mistakes and simple oversights are made all the time... |
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mbrcatz
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If it was an in network hospital, and the doctor is on staff, they need to treat the doctor as in network.
If the insurance company has given you a formal declarations, you need to appeal it. Just a letter that says, "this is an in network hospital and a staff physician, so please pay the bill"
It's not uncommon that this happens, people make mistakes. Unfortunately, it seems like the initial medical bill reviewers make more mistakes than average.
Do NOT EVER ignore bills. It's ALWAYS ultimately the patient's responsibility to pay.
Also, Call these people (hospital, insurance company, etc) every day, because after a year, most insurance companies won't pay. So you're running out of time here, and you need to make sure that people get the job done. In a nice way, so they don't accidentally throw your paperwork away. |
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