First of all, you need to find out if the insurance company paid their part (the contracted rate) because if they did, then filing a lawsuit against them is pointless. Call your insurance company again and this time ask them how much was paid, when it was paid, and how much the hospital was supposed to write off.
It almost sounds like the hospital is balance billing you. That means that the insurance company paid the contracted rate and the hospital is billing you for the rest (which they're not supposed to do if they are contracted). If you went to a contracted hospital, then the insurance only has to pay them the contracted rate and the hospital has to write off the rest of the bill. Then call the hospital's billing department with the information you got from the insurance company. They will probably want a copy of the Explanation of Benefits. If so, you will need to call the insurance company and have them send that to the hospital (or collections agency).
Another possibility is that the hospital is not satisfied with what the insurance company paid them, in which case they are supposed to dispute that with the insurance company, and not you. If that is the case, call your insurance company again and make them aware of this. They should be able to help you resolve this.
2007-09-18 06:02:52
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answer #1
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answered by ~♠♥CJ♥♠~ 6
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Lawyer or lawsuit may be an option, but only as a last resort.
First check
1) Did the insurance company pay the hospital?
a. If so, the hospital should not be billing you. Just have the insurance company send you proof that they paid the hospital and then you send copies to the hospital and the collection agency with a letter saying the bill has been made.
b. If not, ask why. Do they say that you were not insured, that this procedure is not covered, that the hospital charged too much, etc.? That affects what you need to do.
2007-09-18 09:03:38
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answer #2
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answered by StephenWeinstein 7
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Verify with the insurance company what they paid and then verify that the hospital received that amount. Does your policy pay 100% or do you owe a co-pay? There can be errors by both the insurance company and the hospital in their payment and billing departments.
After you get this resolved, make sure that nothing bad is on your credit report from the hospital.
2007-09-19 07:52:09
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answer #3
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answered by Diane M 7
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Guidance for a legal matter is going to come for a lawyer.
But I can tell you, your problem seems to be with the hospital, and not with the insurance company. Have you called the hospital billing department to figure out why they haven't credited the payment from the insurance company??
2007-09-18 02:58:35
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answer #4
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answered by Anonymous 7
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Before filing a lawsuit seek help from the CA Dept of insurance first. Normally, they will try to assist you in a dispute with your health insurance company. Check their website for more info before hiring an attorney that will cost you a small fortune.
http://www.insurance.ca.gov/
Good Luck
2007-09-18 02:38:25
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answer #5
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answered by fighting saints 6
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You hit the significant themes nail on the pinnacle. by regulation, governement-run wellness care classes, which includes Medicare, can't negotiate with the drug agencies for decrease expenses. the result's that many human beings, somewhat decrease income ones, can't have the money for his or her prescriptions, or they take one million/2 doses. advertising of pharmaceuticals could be banned. It forces docs to coach medicine by prescription because of the fact sufferers are available in and tell the doctor what drugs they choose. The doctor writes the script to get the affected person to bypass away because of the fact he receives so little in fee from the coverage firms that he can no longer have the money for to talk the innovations to the afvertised drugs the affected person needs. In my city we've 2 significant hospitals. They each and each have their very own MRI machines, and those machines are high priced! We even have countless autonomous MRI amenities. yet once you're in a hospuital and choose an MRI, the doctor will purely enable you get it interior the scientific institution -- which expenses a minimum of five circumstances as much because it expenses in an autonomous MRI health facility. the government money a terrific variety of the R&D od enormous pharmas. yet whilst the examine ends up in a clean and ordinary drug, the drug business company receives the patent(s) and each and all of the sales. So in case you utilize that drug, you pay two times: First, you pay taxes to help the R&D; 2d, you pay once you purchase the drug. the government could get a professional rata share of the salary from considered one of these drug, which could bypass directly to subsidize government-run wellness care classes. Tort reform would make a huge distinction. Malpractice awards are a small part of the subject. the super and high priced subject is protecting medicine, which motives docs to reserve each and every conceivable attempt to evade the prospect that they are going to get sued. we've the ultimate wellness care in theworld, yet we do not have the ultimate wellness care equipment interior the worldwide. we are utilising many docs out of the occupation because of the fact money to vendors are too low. we've an acute shortage of nurses. How are we going to characteristic 40 six million human beings to the wellness care rolls devoid of extra docs and nurses?
2016-10-04 22:27:12
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answer #6
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answered by ? 4
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