Celebrating 10 years! 2007-2017

Hospital never ran insurance card

I have a family member who was in the hospital a few years a orange903/17/17
Request the itemized statement. Provide that to the insuranc agentdalecooper03/17/17
In what state did this occur? If it is NY, you may want t johnyquest03/18/17
Are you covered by an HMO or a PPO? Different rules apply. guyingorillasuit03/18/17
My first kid was free. severian203/18/17
orange9 (Mar 17, 2017 - 3:59 pm)

I have a family member who was in the hospital a few years ago. The hospital took the insurance information during intake. My family member also required imaging to be done while at the hospital.

This family member just received a bill from a collections company, without ever receiving any sort of bill. Turns out, the imaging at the hospital is a 3rd party, and the insurance information was never communicated. The imaging company is now saying since it is in collections, it is not their responsibility. And collections is saying we are not in the business of billing insurance companies.

Anyone ever deal with this?

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agentdalecooper (Mar 17, 2017 - 4:19 pm)

Request the itemized statement. Provide that to the insurance company. For the most part yeah, it is patient responsibility in the US to make third party payors cough it up. The info the agencies actually have to provide is far more limited than most people assume. Get in contact with the hospital to get the signed consent forms, billing, further itemizations.

You can try to hassle or headache the agency into closing it, but this can backfire if the provider has a downline legal vendor who sues the accounts.

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johnyquest (Mar 18, 2017 - 6:23 am)

In what state did this occur?

If it is NY, you may want to look at the Surprise Bill/Emergency Room Law, which requires notices/consents if there is a hospital which is in an insurance plan but radiologist who is out.

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guyingorillasuit (Mar 18, 2017 - 9:42 am)

Are you covered by an HMO or a PPO? Different rules apply.

Also, don't ignore the adverse effects this may have on your credit history. You shouldn't have to incur a hit because of a bill you didn't know about. Pull your credit history (free on creditkarma.com, and other sites). If you see the tradeline, write a letter to all 3 bureaus requesting a re-investigation, and send it certified mail/RRR.

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severian2 (Mar 18, 2017 - 12:22 pm)

My first kid was free.

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