U
Ultraboy71
Guest
What is the name of your state? Ohio
18 months ago, I had an MRI (one of many in the last few years, as a follow-up to surgery I'd had). My insurance was billed and paid the hospital's claim (the amount paid was like half the amount billed, as usual). I was billed a smaller amount (calculated in the usual manner) and made my payment.
In the last two weeks I have received two bills from the hospital, for the original amount (minus my payment which was made over a year ago). The hospital billing staff I spoke to said that the insurance had "taken their original payment back" due to "lack of prior authorization." I have not received any statements regarding this from my insurance, but have seen this claim labeled "updated" on their CS website (it's now marked "REJECTED 5/29/03"). I'm assuming that the hospital has returned the original payment (which really surprises me).
I'm now very confused (and PO'd) by the fact the hospital is now re-billing me for something that was settled and closed 18 months ago. I do plan to call insurance regarding this, but thought I'd see what anyone who knows more about the legality of this has to offer.
My questions are:
1) Is it legal for an insurance company to retract a payment back from a provider 18 months after the payment was made?
2) Is it legal for a provider to re-bill the patient for the entire amount that was billed 18 months ago, even though they initially received insurance payment, plus a payment from me?
Any advice would be greatly appreciated!
18 months ago, I had an MRI (one of many in the last few years, as a follow-up to surgery I'd had). My insurance was billed and paid the hospital's claim (the amount paid was like half the amount billed, as usual). I was billed a smaller amount (calculated in the usual manner) and made my payment.
In the last two weeks I have received two bills from the hospital, for the original amount (minus my payment which was made over a year ago). The hospital billing staff I spoke to said that the insurance had "taken their original payment back" due to "lack of prior authorization." I have not received any statements regarding this from my insurance, but have seen this claim labeled "updated" on their CS website (it's now marked "REJECTED 5/29/03"). I'm assuming that the hospital has returned the original payment (which really surprises me).
I'm now very confused (and PO'd) by the fact the hospital is now re-billing me for something that was settled and closed 18 months ago. I do plan to call insurance regarding this, but thought I'd see what anyone who knows more about the legality of this has to offer.
My questions are:
1) Is it legal for an insurance company to retract a payment back from a provider 18 months after the payment was made?
2) Is it legal for a provider to re-bill the patient for the entire amount that was billed 18 months ago, even though they initially received insurance payment, plus a payment from me?
Any advice would be greatly appreciated!