Unpaid medical bills...who is responsible.

[chakaka]

I recently underwent an expensive surgery for which I was pre-certified by my insurance company. I am insured through my employer in a PPO. I was informed by my doctors' office that my insurance company is only paying 11% of my bills. My question to you is am I responsible for the other 89% (I am covered at 90% under my policy) of the bills? Thank you for your help...

 

[lawrat]

Hmm. it really depends on what your insurance company meant or means by pre-certified. If you had it in writing that they would be covering at least 90% of your bills, you should have no problem. But because you are the one who received the medical attention, you are responsible for the bills and will have to pay and hope for reimbursement from your insurance company.

To make sure your rights are actually impaired, contact your insurance company and without giving out your name/specific info, ask them if under the circumstances you would be covered. If so, ask them to send it in writing to you via fax, because you are comparing insurance policies.

If you want to go straight to an attorney, try attorneypages.com and look for a medical insurance expert.

Hope this helps.