Doctor's office threatening collection

What is the name of your state? Illinois

I had a baby in June 2001. I had to have an emergency C-section. About two months ago (so over a year after the surgery) I got a bill from some doctor I've never heard of. The bill was for almost 600 dollars.

I called the office to ask what this was for, and they said it was for a surgeon who assisted in my C-section. They said it has been submitted to my insurance company, but was rejected because the doctor was out of network.

I then called my insurance company, who said it was indeed rejected, and I should have checked with them first before having the doctor preform the services.

First of all, it was an emergency! I didn't have time to call the insurance company and ask about anything.

Secondly, I had no idea this doctor was there. I was never asked, or even told, about it.

Thirdly, I gave my insurance information when I checked in to the hospital, which was almost 20 hours earlier. That gave them plenty of time to check to see who my insurance would cover.

Fourth, the hospital was an in network hospital. Doesn't that mean any doctor practicing there is covered?

My question is basically, do I owe this money? If not, should I be going after the doctor herself, the hospital, or the insurance company to pay the bill? Thanks in advance!

[djohnson]

Just some advice from someone thats been there. If your actual Dr was covered and in network and he requested this other Dr to be there. Then there might be something he can sign as referring or it may can go through his office. I had this problem with one of my children. There were 3 Doctors in the office and two were in my network and one was not yet. He was applying but had not been approved as he was new to the prcatice. They each took turns on call and when my son was born the Dr not in network was on call. The same thing happened and I contacted my original Dr who filled out some papers and resubmitted it and it paid then. Sometimes its not what they can do, its how you go about getting them to do it.

Your insurance company must pay. Do not deal w/ the insurance company, go directly to your HR administrator. It could possibly end up being a w/o on the docs part, but the insurance company will show you that on your EOB.