medical claim/bluecross/blue shiled

[lily acosta]

approximately a twos ago (Jan. 18, 1999) i had to have a MRI of my hips done. I called Empire Bluecross/Blueshile about two weeks prior, to asked if it would be ok to have this done near my home town (hackensack, NJ) as opposed to going into New York to have it done. They ok everything (the place, certification). I then proceed to make an appointment at the Hackensack Diagnostic Ima. for January 18, 1999. I showed them all my paperwork, my insurance card and they said everything was fine, sit and the doctor will call in you in 30 minutes to proceed with your mri. Fine, ok, went home. Never heard anything more about anything improper or payments. It has been now about 2 months that i received a letter from the dianogistic place requesting payment of 894.50 and the EBCBS. i called Empire blue cross/blue shiled and they send me a letter rejecting my claim stating that never got precertification from me, therefore, i am liable for this payment. i appeal, citing that if they look into my file they will see that i NEVER proceed with anything unless i call them FIRST and do all the necessary procedures that i must (I am not a healthy person, and had had to have several MRI's, CAT scan, surgeries in the past). I have never done anything unless I FIRST CHECK with them. They replie that it is not on file - so pay up, they are not. what can i do about this. i live on a SSDisability payments (971/mo) and i can not afford to pay this. had i know before hand that I was required to pay this, it never would have been done. am i required by law to pay this, please advise.

thank you in advance for your help in this matter. God bless Lily Acosta

 

[ALawyer]

There are internal processes to appeal this and also write to the CEO of Blue Cross and the NY State Insurance Department.