What is the name of your state (only U.S. law)? OH
I am in a situation where my flexible spending administrator won't reimburse me for the medical expenses I paid. I would like to know what kind of legal actions can I take if I have a case.
The story is I went into the hospital (Cleveland Clinic Hillcrest Hospital) on 1/5 at 8pm when my labor started. Half an hour after midnight, I delivered. So my baby's birthday is 1/6. Due to this life event, I increased my flexible spending account amount (active 1/6) to cover the delivery/hospital service.
Cleveland Clinic billed the entire Room/Board/Delivery for the 1/5 date (when I was admitted), even though it is for 1/5 to 1/8. I requested an itemized bill from Cleveland Clinic to show that the date of service is from 1/5 to 1/8. So, by fsa policy, I should be able to get reimbursement for services dated 1/6 to 1/8. However, the itemized bill responded by Cleveland Clinic only shows the before insurance amount. The insurance adjustment is only reflected as a total. The reason for that is Cleveland Clinic bill the whole Labor/Deliver as ONE package to the insurance company. No one has a real itemized statement at this point.
I have been on the phone with Cleveland Clinic, my insurance company and the flexible spending administrator numerous times and no one is able to provide a resolution. I had asked Cleveland Clinic to rebill this service itemized and they refused! My insurance company couldn't do anything. The flexible spending administrator refuses to acknowledge that the date of service covers 1/6, 1/7 and 1/8 even with the "before insurance" itemized statement.
What can I do next?
I am in a situation where my flexible spending administrator won't reimburse me for the medical expenses I paid. I would like to know what kind of legal actions can I take if I have a case.
The story is I went into the hospital (Cleveland Clinic Hillcrest Hospital) on 1/5 at 8pm when my labor started. Half an hour after midnight, I delivered. So my baby's birthday is 1/6. Due to this life event, I increased my flexible spending account amount (active 1/6) to cover the delivery/hospital service.
Cleveland Clinic billed the entire Room/Board/Delivery for the 1/5 date (when I was admitted), even though it is for 1/5 to 1/8. I requested an itemized bill from Cleveland Clinic to show that the date of service is from 1/5 to 1/8. So, by fsa policy, I should be able to get reimbursement for services dated 1/6 to 1/8. However, the itemized bill responded by Cleveland Clinic only shows the before insurance amount. The insurance adjustment is only reflected as a total. The reason for that is Cleveland Clinic bill the whole Labor/Deliver as ONE package to the insurance company. No one has a real itemized statement at this point.
I have been on the phone with Cleveland Clinic, my insurance company and the flexible spending administrator numerous times and no one is able to provide a resolution. I had asked Cleveland Clinic to rebill this service itemized and they refused! My insurance company couldn't do anything. The flexible spending administrator refuses to acknowledge that the date of service covers 1/6, 1/7 and 1/8 even with the "before insurance" itemized statement.
What can I do next?