my wages are being garnished but my insurance co already paid the hospital

[tanya418]

What is the name of your state? ohio

a hospital files a lawsuit against me for almost $3000. my insurance company paid them and said that i am only responsible for $162. the hospital's attorney said that because a judgement was filed against me and that i didn't follow up in a timely manner i was still responsible for the $3000. my employer received the papers to start me garnishment. i filed an appeal and requested a hearing but the garnishment is going to start before the hearing. what do i do?

 

[cbg]

Critical question: Was this hospital in or out of your insurance carrier's network?

 

[tanya418]

yes this hospital is in network which is stated on my explanation of benefits

 

[cbg]

Then your insurance carrier should be able to help you with this. The hospital has a contract with them as to what fees they are required to accept for insureds of that company.

What you need to do is call the insurance carrier and speak to someone in Provider Relations. (That's what it was called at the carrier I worked for - another carrier may have a different name for it.) Explain that you are being balance billed (that's the industry lingo for what's happening) and that you need their help. What they should do is contact the hospital and point out that under the contract, you only owe $162. In billing you for the balance, the hospital is breaking their contract with the insurer so they should be willing to help.

I can't tell you how long it will take. When a laboratory balance billed me (and I was still an employee of the insurance carrier at that time - not a swift move on their part) it took about three months to get straightened out. If may be that your employer will be willing to hold off on starting the garnishment if you can show them that you are taking pro-active steps to resolve it (if this is a court ordered garnishment they will not be able to hold off no matter how willing they may be). But it's a place to start.

 

[scoobet]

Just a questions........if the insurance company paid this bill you should have received what is called an EOB explanation of benefits. On that it will explain what was paid out and if you are responsible for any monies. Was this inpatient or out patient?
May be several bills you may need to look for.

Is this a large company (insurance, like blue cross blue shield, aetna.....or a small company)?

Was this ever in the hands of a medical collection agency? I asked that because they would have gathered that info while trying to recover the bill for their client (the hospital). If a hospital filed a law suit then the account was probably turned over to collection agency a few times? Do you remember getting calls or letters? The agency will work with you and take what ever payments you can make (most of them, that is their job and of course they try to bully you into a large amount). You try to offer at least 50% of the amount normally they will accept that.

What year did this happen in?

With everything being on line these days I know some insurance companies have their own web sites and if your are a member (have their insurance) you can access the info. I say that because I go into mine to check status of claims often. Their system goes back three years.

In fact I had surgery last year and I can see what the hospital, anesthesia and doctor had all been paid. I had to pay my deductable which is what my plan calls for. My doctor was not paid all that he expected - but he has to accept it because he is on the plan with the insurance company, same for the hospital. They tried to bill me for a large amount also. I sent them the EOB along with a letter and all was forgotten.

I live in NY

 

[ladyc4]

What is the name of your state? ohio

a hospital files a lawsuit against me for almost $3000. my insurance company paid them and said that i am only responsible for $162. the hospital's attorney said that because a judgement was filed against me and that i didn't follow up in a timely manner i was still responsible for the $3000. my employer received the papers to start me garnishment. i filed an appeal and requested a hearing but the garnishment is going to start before the hearing. what do i do?

If the hospital-or someone acting for the hospital-got a judgement against you,how did they do this without your being notified? You should have showed up at the courthouse with every scrap of paper you had regarding the bill,and whatever is in writing that establishes that the hospital HAS to settle for what the insurance co deems appropriate. If you were never notified of this lawsuit against you, then you may have some recourse. Did the insurance company not pay the bill until the lawsuit was filed?
I strongly suggest you consult an attorney in your community.