A UMC Quick Care hospital is charging my visit as emergency treatment. Do I have a case?

Question

For all you law buffs out there, I went to a UMC Quick Care clinic for back problems. They charged me the copay that I usually pay for primary care visits instead of the much higher ER copay. Later I come to find out that they charged the treatment as emergency care and my insurance won't cover it. Now UMC refuses to bill the visit as a normal primary care visit so I'm stuck footing the bill. Can I take them to small claims court since they never never told me they were charging me for emergency care?

Please help!

Update: I already spoke to their billing department and they have sent the bill to collections. They won't talk to me any longer. I asked how they could do that while I was still contesting the charge and they replied that it was because I didn't send in anything in writing. The first bill I received was in October of 2006. They sent me to collections after only 3 months!

Now what can I do?

Answer 1

Now you could attempt to send a certified letter to the billing department stating you were charged the copay because it was not considered a emergency treatment at the time of service and there has been a billing error. Tell them you paid your copay for the primary care visit. Ask them to rebill your insurance company appropriately as a primary care visit not an emergency visit. Could be they will reconsider. Billing errors happen all the time, a wrong code is entered by the physician and the medical coding department sends the wrong claim to the insurance company. But don't conduct this over the phone, you will get better results if you keep copies of all correspondence.

Send the letter to the supervisor of the billing department. Call the billing department and get the name of the head of the billing department. Keep a clear head and don't be rude. Tell them you understand billing errors are common but would like this situation remedied immediately. Don't bother fighting this on the phone, you want to ensure they know you are documenting everything, sometimes that in itself will assist you, as they may just decide to avoid the hassle.

You can also file a appeal with your insurance company.


Good luck!

Answer 2

I bet it was somewhere in the small small print of one of the 80 forms they made you sign when you went in...sigh. I so hate our health care system nowadays.

Anyway, if you have a receipt stating it was a primary care visit and you paid the primary care co-pay, I would call your insurance company and let them argue it out with the Quick Care. Don't send anyone anymore money until they get done with their internal investigation. I'd also call the billing department at Quick Care and ask for a supervisor, stick to your guns and see if you can get it knocked down to the right amount. They have a huge amount of discretion to work with on this front.

Small claims you'd lose, they'd just pull some piece of paper out and you'd be all done, plus you'd be out court costs, too. Much better working through the insurance and billing department.