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December 2013 Moms
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Long! Need advice/help with medical billing & insurance

Tigger & poohTigger & pooh member
in December 2013 Moms
Right after we had Kate we received all our bills from the perinatologist and hospital. Immediately after receiving that Bill I called to tell them that all the charges from the perinatologist were wrong because they have the insurance information incorrect. Every month since then I get a bill with the same incorrect info and I call to tell them it is wrong. I have on multiple occasions told them I need this fixed and will not pay the bill until it is and that I don't want this being sent to collections because it is their error. Well today I received another bill this one stating it is a final bill. The primary insurance is still listed incorrectly but now they have taken an uninsured discount off. The problem is they still haven't sent it to the correct insurance company. And now they are threatening to send it to collections. I am not sure what to do at this point. Do I just pay it with the uninsured discount and hope it is the same as if my insurance had been run correctly? Part of me thinks they ran it this way because they took so long to send it to the correct insurance that now the insurance company refuses to pay it but that shouldn't be my problem should it? I did my due diligence for almost six months now. Can anyone offer some guidance?
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Re: Long! Need advice/help with medical billing & insurance

  • stinkerbell2006stinkerbell2006 member
    I would go in directly and meet with the appropriate person in the billing department. 
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  • Tigger & poohTigger & pooh member
    So after typing this and calming myself down I read over the bill closer and found a number for in Person discussions regarding bills. I called them and have an appt. on Tuesday at 11.
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  • BootsOrHeartsBootsOrHearts member

    Yes it's very possible that they took too long to send it to insurance and now insurance won't pay. Depending on the state you live in and the contract they have with your insurance company, they have to send it within X days of the service or they pay nothing, but you're correct, it's the hospital that has to eat that, not you! You still may owe your copay or coinsurance but not the rest of it.

    Suggest calling your insurance company and explaining. Often they will do a 3-way call with the provider billing office and explain who is responsible for what charges.

    Also agree with asking to speak to a supervisor or the billing manager and explaining the situation.

    What a mess I hope you get it figured out!

    I had a similar problem with the hospital billing my 2 insurance companies in the wrong order so of course neither paid and it took months to correct, I never did understand what the problem was, why they didn't just update the info and rebill everything. I can only say that I think most billing offices are understaffed and the staff they have are often undertrained and underskilled.

    **Warning: Losses and living child mentioned**
    BFP#1 1/31/12, EDD 10/6/12 Harrison Gray born sleeping @ 18w6d. You changed our lives little guy.
    BFP#2 EDD 10/29/13, C/P 2/25/13, Bye little Ish, we barely got to know you.
    BFP#3 EDD 12/21/13, Baby Boots born 11/23/13 My rainbow baby!
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  • Tigger & poohTigger & pooh member
    Some of the charges are now over a year old so we will see what happens. I don't know why they waited until I have birth to send me a bill. I don't have that insurance anymore so that complicates things too. That insurance also had a high deductible so who knows maybe the uninsured discount is better than what the insurance company has for an allowed charge but I just want it done right.
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  • Tigger & poohTigger & pooh member
    hercules03 said:

    I would submit it insurance on my own. They don't have to do that for you -I mean they are supposed to, but if they keep screwing it up, do it yourself. :)

    The problem with that is the insurance isn't technically paying anything. We had a high deductible plan so all the office needs to do is adjust each charge to the charge allowed by insurance and then I am responsible for that total amount.
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