hospital refuses to send bill to health insurance

[dar756]

What is the name of your state?IL.
i was in auto accident hospital refuses to send bill to my health insurance company. Hospital states since it was an auto accident they dont have to. that the person that hit me has to pay it. Well we all know that can be tied up for years. The person that hit me is denying liability. Its been over a year so the time is up for them to submit it now. Now the hospital wants me to pay the full amount. I talked to my health insurance company and they stated i had no exclusions in my policy that even though auto accident it would have been paid at my plans benifits which would have been 100% after 300.00 copay. this bill is almost 4,000.00. They stated that they believe their is a law that they have to take it as a loss since they did not file with in a timely matter which is 1 year. please help i shouldnt be stuck with a bill when i had health insurance that would have covered it. the only thing i could think is they would have had to take a ppo deduction and they were trying to be sneaky and get the full amout. what do i do. thanks in advance.

 

[pojo2]

What did YOU do to try and resolve this BEFORE the time limit expired. Could you not have taken your bill from the hospital and submitted it yourself to the INs. Co? Why only AFTER the expiration did you talk to the Ins. Co. and not before?

 

[dar756]

i didnt know their was a time limit when i called the insurance company to see if their was something i can do they told me i could submit it my self and told me what to ask the hospital for. when the health insurance asked me the date on the bill then then told me it was past a year that i could not submit it. i never new their was a time limit until they told me and it was to late. why now am i doing something all the bills i recevied up until last month from the hospital said pending insurance this is not a bill. I believe the hospital new what they were doing once it hit 13 months they sent me a regualar bill stating i owed it. they were trying to get the money from the auto insurance once they told them their not getting it now they want me to pay. This shouldnt be my fault. Their has got to be somthign out there to help me.

 

[lkc15507]

What is the name of your state?IL.
i was in auto accident hospital refuses to send bill to my health insurance company. Hospital states since it was an auto accident they dont have to. that the person that hit me has to pay it. Well we all know that can be tied up for years. The person that hit me is denying liability. Its been over a year so the time is up for them to submit it now. Now the hospital wants me to pay the full amount. I talked to my health insurance company and they stated i had no exclusions in my policy that even though auto accident it would have been paid at my plans benifits which would have been 100% after 300.00 copay. this bill is almost 4,000.00. They stated that they believe their is a law that they have to take it as a loss since they did not file with in a timely matter which is 1 year. please help i shouldnt be stuck with a bill when i had health insurance that would have covered it. the only thing i could think is they would have had to take a ppo deduction and they were trying to be sneaky and get the full amout. what do i do. thanks in advance.

First, I know you will hate this, but you are wholely responsible for the accurate payment of your health care bills. If you have health insurance, you should have or you should have asked for a summary plan document, which would explain the 1 yr limit. The facility has absolutely no obligation to file such claims for you. Even if a facility / provider assures you they will, it is only a courtesy. Now after all that, I agree that if a facility accepts assignment of benefits, the same should accept responsibility for the outcome. However, that is not the case.

Now for my high horse forum. READ those plan documents, do not ASSUME that insurance will pay for what you think it will! Insurance is NOT a BLANK CHECK, you have to follow the rules! Insurance will work when you work with it!