Well being Insurance coverage not paying invoice they confirmed can be 100% lined with no copay. Not refusing to pay, simply… Not paying.

By | June 15, 2019

***Posted in r/legaladvice and was inspired to submit my questions right here, too. I’m not certain what to do or who I may even escalate this to, however I’m hoping I can get some recommendation on this subject with my medical insurance. TL;DR — Had surgical procedure that was alleged to be lined at 100%. I maintain getting payments for the surgical procedure for over $6,000. Each time I discuss to my insurance coverage, they apologize and make sure that they completely are accountable for the invoice and I am appropriate that I ought to owe nothing. They then do/pay nothing and I maintain getting payments. The payments I bought as we speak are “closing notices” earlier than they get despatched to collections. Assist. So, I bought my tubes tied in January of this yr. Earlier than I scheduled the process, I referred to as my medical insurance (PreferredOne, by way of my job) and confirmed the coverage said on-line that sterilization procedures are lined at 100% with no copay, together with any hospital/restoration/anesthesia charges. The lady I spoke with confirmed that sure, all of this was lined. So I scheduled the surgical procedure, and after my pre-op appointment, my physician faxed a pre-authorization letter in to the insurance coverage firm confirming the process and date it could happen. Clearly, the day of the surgical procedure the surgical procedure heart made photocopies of my insurance coverage data and ID. So, in a nutshell, since my surgical procedure in January I’ve repeatedly gotten payments within the mail from the surgical procedure heart and the anesthesiologist individually. In whole, I’m being billed for over $6,000. Right this moment I bought a fourth spherical of payments, each marked that that is my closing discover earlier than the payments are despatched to collections, which REALLY stresses me out. Principally, each time I name the insurance coverage firm (which I do a number of instances, every time I’ve acquired a invoice over the previous couple of months), they affirm over the telephone that I’m 100% appropriate — the surgical procedure and surrounding care is roofed at 100%, they do have my pre-authorization on file, all of my data like DOB, SSN, and many others. are listed accurately. They affirm that there are not any points or discrepancies and it’s completely clear-cut on their finish that this invoice must be totally lined. They then apologize profusely and say they are going to kind out fee to the surgical procedure heart and anesthesiologist instantly. Then they do nothing, and some weeks later I get one other spherical of payments. I nearly really feel like I’m being ghosted — they affirm all the above data, apologize, after which… Do nothing and do not pay or discover any decision for my payments. So my questions are: Who can I probably escalate this to? I’m in a single state, my employer is in one other, and the insurance coverage firm relies in a 3rd. I am in MN if that issues in any respect, however I assume the Lawyer Common right here has zero jurisdiction over the insurance coverage firm, which relies in FL? Can they actually simply ignore the invoice again and again till time runs out and my payments go to third-party collections, even after confirming repeatedly that they need to pay? I feel essentially the most irritating half is that they’re contesting nothing, but simply… should not paying? If this will get despatched to collections… What can I probably do? I clearly haven’t any intention of paying, however I’m very accountable with my payments/credit score rating and I am burdened to no finish about this going to collections (which it should if nothing is paid by 7/1, per each “closing discover” payments I bought as we speak). I’d actually admire any and all recommendation… Thanks. submitted by /u/a_live_dog [link] [comments]