Hospital wants money

[littlefish]

What is the name of your state? Virginia

I received a call from the Hospital's billing office requesting $8,038.75 for a Dec. 2003 procedure. According to the billing office the Insurance company and the Hospital had put it on hold. The billing office states we must pay it because the Insurance company has now refused. I no longer have insurance with this company and do not feel I should be held responsible. Can the hospital bring a judgement against me? Please let me know if
there are any statute of limitations or some other legal avenue that can be pursued in this matter.
Thank you so much,
Littlefish

 

[Texas Pooh]

Why do you think you shouldn't be held responsible?

You had the procedure done. You are responsible for paying for it. You had insurance, and were responsible for ensuring that you did whatever was required under the policy to make sure it was covered (for example, prequalification, in network v. out of network, managed care, etc).

If coverage was denied, you got a notice indicating that coverage was denied. You must appeal denial using the required procedures. If you did what was required, an appeal should be easy. The fact that you don't have coverage now doesn't mean you can't appeal.

Regardless, you are responsible for deductable/co-payment.

 

[xylene]

You need a lawyer straight away.

You do not want a judgment.

DO NOT PAY ANYTHING, even a 'good faith gesture' until you talk to a lawyer.

 

[SimpleMind]

yes

You probably need to get a lawyer on this one. In short, You are responsible for items insurance doesn't cover. Chances are you probably signed papers from the hospital before the proceedure which clearly explained that. You can still fight this with the insurance company..

Let this be a valueable lesson learned. When it comes to insurance companies, hospitals, and doctors you really need to stay on top of this. You can't let an $8,000 bill fall thru the cracks and expect a hospital to forget about it. It will always come back to haunt you. I am speaking from experience. If the insurance didn't cover it by about the 3rd month or if insurance never was billed.. You should have been on the phone everyday asking about it.

 

[ecmst12]

The main things you need to find out:

Was the hospital contracted with your insurance company at the time?

and

Why was the claim denied?

Post back with the answers to those two questions and I will tell you whether you are responsible for the bill.