What do I do in this situation?

[Vaneese]

Medical procedure where insurance was never submitted or submitted incorrectly. At the present time, insurance has reached its limit for the year, but at the time of service, it had not. What are my options at this point? Will I just have to bite the bullet and pay the entire amount because of the hospital's screw up? Any advice is greatly appreciated...

 

Oh and Hello everyone, I'm new...

[bonbonXO]

What is your insurance's company's policy on length of time that claims must be submitted in?<br />Mine is 2 years and I know others are only year.<br /><br />This a little screwy if this claim was submitted in time and paid than another later claim would not have been paid, and you would have been responsible to pay for a later claim. So it is like pay them now or pay them later, if that make any sense. <br /><br />I am assuming this is recent and not on your CR, if not please correct me if I am wrong.<br />

Edited August 20, 2008 by bonbonXO

[Why Chat]

Medical procedure where insurance was never submitted or submitted incorrectly. At the present time, insurance has reached its limit for the year, but at the time of service, it had not. What are my options at this point? Will I just have to bite the bullet and pay the entire amount because of the hospital's screw up? Any advice is greatly appreciated...

 

Oh and Hello everyone, I'm new...

Welcome to the forum.

 

We need some more information before we can help you.

 

When was the "medical procedure"??

Is this a collection account on your credit reports??

Is this a bill from a Dr. or is it from a hospital??

 

Do you have an EOMB ( explanation of medical benefits) from your insurance?

 

You can use the HIPAA letter system to get this off your reports, ( if it is on them)

 

First, Opt Out--You can make one phone call to 1-888-567-8688 [1-888-5-OPTOUT] to opt-out .

Next, try to get old addresses deleted from your reports if you have moved since the "medical procedure".

 

Then send this to any CRA ( Credit reporting agency) where this account is appearing, you can get your credit reports directly from each CRA, To order, visit annualcreditreport.com, or call 1-877-322-8228, do NOT try to use any "3 in 1" or credit monitoring service reports as they are not useful for disputing purposes.

Make sure you follow the directions.

http://whychat.5u.com/hipaadisp.html

 

If you would post back ON THIS THREAD after you have answered the above questions, and after you have a response from the dispute letter , ( allow 30-45 days) you can get additional help if you need it.

 

In general, if the "bills" are not "real" bills but left over discounted/written off balances that have been picked up by a "garbage" CA ( collection agent) they can be disputed away. If they are "real" bills that were not properly sent to your insurance or had incorrect coding, you can write or call your insurance Co. and get a statement from them ( in writing) as to the reason they weren't paid, or if they were never submitted, and a statement from them as to their procedures and time limits for a correct resubmission.

 

With THAT letter, you can send the HIPAA letter insert "b" to the health care provider.

http://whychat.5u.com/hipltr.html

 

The issue of the billing date falling into another year has no relevence, your insurance deductible is based on the date of service, not the date of billing.

[Lwhitfield]

If the hospital failed to submit the claim timely, it is not your fault. Unless it was your fault that they could not submit the claim. You can fight this if you gave them accurate information, if they billed you appeal to your insurance company and tell them the reason that this was not done in a timely manor and they may pay ever though it is over the time limit. I've seen it done.