Doctors bill, Paperwork, Debt collection

[Absecon1]

What is the name of your state? What is the name of your state?New Jersey

I needed Surgery. My Primary care Phys. sent a referral to the surgeon. The surgeon called for a Pre-authorization number. He provided that number to the Hospital and the Anesthesiologist.Now, after the fact I learn The surgeons office called the WRONG insurance company for an appoval. they made the mistake and the Anestesiologist has report me to a collection agent. I have perfect credit until this mess. I don't see how I should have to pay up. The surgeon should be liable for the expenses of the hospital and the rest. Am i right?

 

[I AM ALWAYS LIABLE]

What is the name of your state? What is the name of your state?New Jersey

I needed Surgery. My Primary care Phys. sent a referral to the surgeon. The surgeon called for a Pre-authorization number. He provided that number to the Hospital and the Anesthesiologist.Now, after the fact I learn The surgeons office called the WRONG insurance company for an appoval. they made the mistake and the Anestesiologist has report me to a collection agent. I have perfect credit until this mess. I don't see how I should have to pay up. The surgeon should be liable for the expenses of the hospital and the rest. Am i right?

My response:

How, praytell, did your doctor get an "authorization number" from an insurance company of which you're not a member/insured?

Something is fishy. Are you SURE you told us all the pertinent facts?

IAAL

 

[Absecon1]

Number and payment

Not only did he get a number , they were paid . They denied it until I pointed it out to them on my bill for the surgery .It plainly showed a Ins.payment of 586. bucks. Then they said, "oh we'll have to send that back.

Anyway, they screwed up the paperwork, am I responsible for the mess?

 

[Beth3]

I'm absolutely astonished that an insurance company who never heard of you paid the bill. I can't even imagine how that's possible - you wouldn't have been loaded into their claims system by the Eligibilty Department, which is purposefully an entirely separate group from Claims as an internal "checks and balances." Employees who pay the medical claims have NO ability to enter claimants into the system. When the bill arrived in Claims, they would have no record on their system of you being an insured. Theoretically, the system shouldn't have been capable of issuing a check to a medical provider on your behalf, unless your medical bill was submited under the wrong name, wrong ss# and wrong group # and all that happened to match someone else who was in their system. The odds of that happening are pretty darn remote.

I'm not disbelieving what you're saying; I just can't imagine how this happened.

Has your own insurance carrier denied all payments because of the pre-authorization mishap? Have you explained to them what happened? If so, what have they said?

 

[HomeGuru]

All I can say is Huh?