I owe $500 in Medical Bills, after going to a hospital outside of my insurance plan. What can I do?

Question

I went to an out of network provider for a simple procedure that was covered under my insurance plan. However, because I went to the wrong hospital, I owe $500 for services that would have cost me next to nothing. Is there anything I can do to at least lessen the cost?

Answer 1

You can appeal the bills. Call your insurance company and see what the proper procedure is for doing that. Explain that you didn't know that the Dr was a non par provider.

Answer 2

Unless there is not a hospital within reasonable distance from where you were like 50 miles then you are going to be responsible. If there are no hospitals within network then they would have to supply in-network benefits as long as you have a note from the physician stating it was necessary procedure. Sometimes if you call the hospital they will nego a pay off for a little less than that bill but you would have to pay the nego rate in full.

Answer 3

Unfortunately, all that paperwork you get when you sign up for you insurance plan (evidence of coverage) pretty much spells this out, so its pretty cut and dried. The good news is, sometimes you can make a good enough case that they will just write off the debt. My suggestion is to call your plan's member service people and find out what their process is for appealing the bill, come up with your story and write a good letter. It may take a little work, but it may be worth the effort. The $500 is less than it will cost them to go through the process of working the appeal. Good luck.

Answer 4

What benfit plan do you have.? HMO, PPO, POS Was it an emergency? If it was an emergency and the non/ntwkd hospital was the nearest location you could appeal this with your insurance company. You could tell them it was an emergency and the non/par hospital was the nearest. Sometimes what the insurance companies will do is reprocess you claim in network since it was emergency. If they reprocess your claim you would receive the networked discount and it would be processed according to your benefits at the time of service. ie, deductible, coins, er copayment etc...

Answer 5

The same thing happened to me when I had my son. Though I was in an "in network" hospital and my delivery doc was "in network" the doc that did my epidural was not "in network". I was in so much pain, i didn't take the time to stop and confirm if he was in network or not, i just assumed he was since i'd made it a point to everyone that's what I needed. Anyway, i refused to pay the bill, they wrote it off and that was that.....and yes my credit is fine!

Answer 6

That's the reason I don't like the concept of HMOs: A bunch of suits who have no real notion of what you're dealing with are trying to tell you who you can see for your problems.

Some years ago I got stuck with about $2000 in medical bills that I shouldn't have had to pay because of beaurocratic red tape. However, the hospital was willing to work with me to set up a payment plan.