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Hospital - Administrative Malpractice

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desertjim

Junior Member
What is the name of your state? New Mexico

It's hard to make this quick and short!

In Oct 2004 my wife needed a procedure. We contacted the hospital and gave them our medical insurance info. They said the procedure wasn't covered. They said "bring money". I asked how much and was told $2500. Because the doctor stressed the urgency of it, we didn't really check any place else (we should have).We went in to schedule the procedure and filled out the necessary paperwork. I gave them a check for $2500. Before we signed the paperwork, the lady processing us informed us that there was two places to notice and "check" on the admission forms:

1. Was to bill the insurance company
2. The other was for "no insurance"; that in this case the $2500 would cover all the hospital expenses (but not the doctor); even if it was more the hospital would absorb the overage; that the insurance would not be billed.

I thought nothing more about it.....until......I get a notice from the insurance company that the hospital had billed them almost $7000. Right away I became suspicious of the whole
billing procedure.

I called three local hospitals and found that the costs for the procedure ranged from less than $1000 to $1250.00. I then determined to confront the hospital about it. The long and the short of it was that the hospital agreed to refund the difference between $1250 and $2500. Some was applied to some other bill which probably was included in the price of the hospital admission and we received a check for the balance.

The above is the main crix of the matter. However the hospital has been over paid a lot of money and refuse to refund it. After the procedure they billed me for about $1000 in lab and testing costs, which were supposed to be included in the original hospital charge. I paid it and was ultimately, after a couple years of hassle, was refunded $58 in overpayment. I shoud have had it ALL returned. I finally was able to get my insurance to pay seven hundred and some dollars from the original billing and the hospital refuses to refund me.

This has been going on almost two and a half years. I have talked to every person at the hospital who "should" help me, but most don't seem to have a clue about anything.

I'm at a brick wall.

I am more concerned about getting this in the courts and into the community than I am about the money. The hospital doesn't have much of a reputation around here and quite frankly I wouldn't take a dog there. Alas, I found this out too late.

I'm going to file a complaint with the State Attorney General's Office.

I'm also considering seeing if an attorney would want to represent me, but it's such a small amount, they might not even look at it.

What about punitive judgement!!! The plaintiff can't ask for punitive damages can he?

I really feel this is a case where they should be slapped quite hard across the face rather than the wrists.

What do you folks think?

BTW: A word of advice - If ever you need a non-ememgency procedure, "shop around".

Regards,

Jim Dykes
Deming, NMWhat is the name of your state?
 


Zigner

Senior Member, Non-Attorney
I think this is a small claims matter. Gather your documents and sue the bad people in small claims court.
 

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