Comments on: Do I legally have to pay for a hospitals insurance billing mistake?

By: janet m

janet m — Tue, 21 Oct 2008 18:49:16 +0000

you might need to go to the hospital accounting department & have them call the insurance company for their mistake. it’s going to ruin your credit & you did nothing wrong. call the insurance company & speak to a claims manager & tell them exactly what happened & if they still won’t pay tell them you want to have the hospital bill appealed to their claims dept. the hospital made the mistake but unfortunately you need to clean up their mess.. good luck

By: Katie

Katie — Tue, 21 Oct 2008 05:22:28 +0000

If the hospital is in network with the insurance then no, they cannot bill you. Call your insurance company (the one they should have submitted to originally) and let them know you are being billed and they will contact the hosptial to tell them to stop blling you.If the hospital is out of network with the insurance, then they technically can bill you. Whenever you go out of network, it’s up to you to make sure they are billing properly and doing whatever they need to do to get paid since they are not contractually obligated to do anything with the insurance company (billing, etc…).

If they are out of network, I would suggest filing an appeal with your insurance company asking for an exception since you were unaware there was a problem.

By: MVD34

MVD34 — Sun, 19 Oct 2008 04:28:00 +0000

Probably not, but prepare yourself for a big hassle.

First, stop talking to collection agencies. They cannot help, nor do they care. They lie. They cheat. They bend and break the rules. Refuse to talk to anyone on that side of the table except the hospital. Despute the item on your credit report and check the laws about resolving credit issue concerning medical bills in your state. Some states (California) have very strict rules that people like you do not know about and, therefore, don’t ram down the throats of hospitals and other care providers.

Second, can you prove you gave the correct information to the hospital? If so, you are on solid ground. If not, you may have to play “extreme hardball” with the hospital. Call your HR department. Have all your facts straight and the evidence in front of you. Ask them to help you resolve the issue with the hospital. Most employers of any size have a person who will act as a go-between for employees and the insurance company.

Third, if your company isn’t able to help you, go to the hospital in person and make an appointment with someone who can help you. If you have a reasonable amount of evidence on your side and you understand the laws of your state regarding medical bills, you will have what you need to settle. Be polite but firm. Honest, but reserved. Know exactly how much the law says you owe, how much your insurance would have paid, and how much you can afford. Most of these negotiations start with the price your insurance would have paid if the filing had been done properly. They “pay” 50%-75% and you pay the rest at $50/month with no interest or penalties…and they take the ding off your credit report.

By: Obamanized

Obamanized — Thu, 16 Oct 2008 22:12:48 +0000

When you go to the hospital and they ask you ” Do you have insurance?”
I’m assuming you said “Yes”, did you also tell them that you changed insurance companies?
I know for a fact that every single time I go see a doctor they ask you, you still have to fill out a form of one kind or another.
When they give you a copy of the bill, it shows what insurance company is going to cover you.
I’d pay it, because your insurance company can claim neglect or your part, they are going to show your original receipt with your signature showing the wrong insurance on the bill.
They are not liable for that.
Another thing you’d want to avoid is fraud, the hospital or collection agency could claim it as such if you don’t pay them.
Just pay the bill, and think of it as a learning experience.

How much is it by the way?

By: src50

src50 — Mon, 13 Oct 2008 11:57:23 +0000

It was your responsibility to insure that the hospital was provided with your correct and current insurance and address information. You are ultimately responsible for anything not paid by insurance. ALWAYS follow up on medical billing to ensure that it is processed correctly.

By: Jeanbug

Jeanbug — Mon, 13 Oct 2008 07:43:32 +0000

You won’t like my answer but…..
Hospitals and physicians always have patients sign a disclaimer that we (the patients) are ultimately responsible for our bills, regardless of insurance or whatever. This means that it is OUR responsibility to make sure these things are taken care of. Didn’t it even occur to you in those 9 months that “Gee, I never got a bill from the hospital? or a explanation of benefits from my insurance company?”

Or did you think they were giving you a free pass to your visit to the ER?

Legally, the hospital doesn’t have to do anything. What I would suggest is to call the insurance company, speak to a supervisor, and have them resubmit the claim. If they won’t cover it, then you need to make payment arrangements with the hospital (or collection agency).

By: Starlight

Starlight — Fri, 10 Oct 2008 16:53:45 +0000

Usually when you visit a hospital or any doctor’s office, the paperwork you sign states that, while they may bill insurance, you are financially responsible for the bill. You can try contacting the insurance company representative to explain your case. Request a copy of all billing records from the hospital to show the insurance company how they billed the wrong place. In the end, though, you are responsible.