What to do about this doctor bill?

Question

Last year I was taken to the ER doctor. I ended up in the waiting room for nearly 12 hours and did not see a doctor. They took blood work. Sometime after, i received a bill saying I owed them money for labs and seeing the doctor. I was told that I had to pay the bill despite not seeing the doctor so I updated my insurance information. It did not seem like it went through so I sent the payment. Now nearly a year later I receive a statement saying the insurance paid about 15% and I owe the rest. Is this normal to have this go through so long after I submitted? How do I go about this since I already made the in full payment?

It seems strange that it took so long for them to bill my insurance and I wonder if that is even normal.

No I did not even speak to a doctor. The only person I had contact with was the nurse who accessed my history and did the labs.

Answer 1

I agree with the others, you are due a refund from the hospital.
Also, by law, if you request a full copy of your files from a medical provider - they must provide it.

You need to contact your insurance company and find out why they only paid 15% of the bill. Find out if that is the amount the insurance company would only cover you for OR if the hospital failed to properly file a claim. Request that the insurance company send you the reason in writing !!!!!!!!

If the hospital failed to properly file a claim - you owe them nothing - nada - zip. Tell them to refund your money and to refile a proper claim with the insurance company.

IF it is to late for them to file a proper claim (many times insurance companies have a time limit for claim filing) tell the hospital that you are not responsible for it since they failed to properly submit a correct claim.

If the hospital failed to properly file a correct claim and still gives you the run around, won't refile the claim, expecting "you" to pay etc. - tell them you have rights under HIPAA and you are not responsible for the debt.

If you need to use the HIPAA reference, you might click on my profile and go to the last site I have listed. Then go to the medical forum and read about it.

Answer 2

I am sorry for your 12 hour wait at the hospital, depending on the diagnosis and how busy it is, hospitals usually take most critical first. On the second hand you can request your chart! Did the doctor talk to you at all? Prescribe anything? Even though you were not taken back, if you briefly talk to him they would definitely consider that as being seen. Make sure your medical, record number, SS# and DOB are correct there could be a mistake. If you have a common name there could be other patients they may have crossed with yours.
Good luck it will take some time to research

Answer 3

copy the recipt for payment or your check and forward a letter to the hospital billing department requesting a refund of the difference because of the insurance payment.

Protest the doctors charge since yo didnt see one . HOWEVER if you had blood work done a Doctor may have reviewed the tests and decided treatment . It MAY be a valid charge , but its bad medicine .

Send a letter to the hospital administrator that you feel the charge for the doctor was excessive since you did not see one . ask for an explanation.

Answer 4

Show proof that you paid the entire amount, such as a canceled check. Then ask for reimbursement for the amount that the insurance company finally paid. They cannot keep your entire payment and the payment from the insurance too. They owe you some money.

Answer 5

You should talk to your insurance company and ask them how much they cover. I know certain insurances cover only about 80% of it, and the 20% is paid by pocket. You need to talk to your insurance provider, they will give you in detail.