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Dispute w/ a hospital bill

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Wendy_momof4

Guest
What is the name of your state? Oregon

My name is Wendy and I have a dispute w/ a hospital bill that I recieved. This takes us back almost two years to June of 2002. My twins were turning 2 years old and my doctor informed me that their speech was not up to par w/ their age, she suggested speech therapy and reffered me to a speech therapist. She told me that the speech therapist would be able to make a proper diagnosis and check the childrens hearing. I met w/ the speech therapist who signed me up for speech therapy and said that they would evaluate the children during the session, then they would give them a hearing test. We started speech therapy and went once a week and then bumped it up to two times a week starting in July because they didn't feel like the children were making progress. Still no hearing test had been done on the children. When I asked them they would say "Well we will do it next time they come in, we forgot the equipment". Finally in August I asked again when the hearing test would be done and they said they would give me a referal for another clinic in Portland, that they had better diagnostic tools to check the childrens hearing. Finally at the end of August I pulled them out of speech therapy because I recieved a bill and the insurance had denied the claim. I asked why they denied the claim and it was because my family physician ( the phsycian who reffered me to the speech therapist) had put that the children had a developmental delay. My point is how do you diagnosis that without actually doing a hearing test on the children. When I took it up w/ the doctor, which by this time was on maternity leave and the new doctor would not get involved in the case, the billing department said there was nothing that they could do, the doctor was refusing to change the diagnosis and resubmitt to the insurance due to legal reasons. When I spoke w/ the hospital where the speech therapy occured, I was told that they would resubmitt but probably would come out w/ the same denied status, which it did. Now I am being sued by the hospital for my refusal to pay, I owe $5000. I am just wondering if I have a legal leg to stand on or do I have to pay. They refuse to settle w/ us, they want the full amount but agreed to take off $500.00 of interest. I have 20 days to pay or set up payment plan or they are taking us to court. If there is anyone that can offer any advice, I would greatly appreciate it. Thank you for your time in reading this, I hope I was clear in explaining my situation.

Wendy
 


Beth3

Senior Member
I don't see that you have any other option but to pay. You are responsible for payment of services rendered, even if you don't care for manner in which the referring doctor coded the diagnosis and even if your carrier denied the bills. Your option is to appeal your carrier's decision all the way up to your State's Insurance Commission if you wish but you do not have the option of refusing to pay the hospital for services they performed.
 
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Wendy_momof4

Guest
Thank you for your time in responding, I was worried that was going to be the answer. I will pay and chalk it up to lesson learned!

Wendy
 

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