Hospital Not Under Contract Posted: 03-01-07 12:41pm
Recently, I was seen by a hospital that
was not under contract with my health
insurance. I repeatedly asked the check
in people and nurses about whether my
insurance was ok and they kept telling me
it was ok. I also asked whether or not I
needed to contact my insurance company.
They said they would take care of
everything and that it should all be ok.
With out getting into too much detail,
I've had almost $10,000 worth of
visits/procedures done by this hospital.
(This is actual cost).
Now, my insurance is willing to pay for
their portion of the costs but since they
are not under contract with this hospital,
the usual deferred part of the bill has
been fitted to me.
Now, I do not know what to do. It seems
pretty ridiculous for me to have to pay
for the whole bill because someone at the
hospital didn't check to see if my
insurance was under contract. I could
have easily gone down the street to a
different hospital, which was under
contract with my insurance and not had to
have paid the deferred portion of the
bill.
Any advice would be much appreciated.
Thanks in advance.
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SunflowerRN
New User, Becoming EHEALTHy
Joined: 14 Mar 2007 Posts: 1
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Posted: 03-14-07 12:04pm
Unfortunately, you as the member are
partly responsible. Instead of checking
with the hospital, who may not understand
fully what type of plan you have and what
it covers, you should've checked with the
insurance company to be sure.
I work for an insurance company and too
many times we receive calls from members
wanting us to cover out of network
services as in network either because they
don't want to use our network or because
they weren't aware dr/facility was out of
network. Members need to take
responsibility, not just hospitals or
physicians.
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millergold
New User, Becoming EHEALTHy
Joined: 01 Mar 2007 Posts: 2
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I Understand Posted: 03-20-07 20:18pm
I appreciate your response. I am more
than willing to take responsibility for
not checking with my insurance company.
It just frustrates me when I repeatedly
asked the hospital if everything was ok
and they said yes. I guess the moral of
the story is that hospital secretaries are
idiots and that you can't trust them.
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Sunflower_pie81
Especially EHEALTHy
Joined: 17 Jan 2006 Posts: 5041 Location: to hell with this crap
Thanks: 0
Thanked:0
Posted: 03-20-07 20:30pm
I work in insurance, and i see this happen
to a lot of people; however being the
subscriber to the insurance it's your
responcibility to check to see what
doctors/hospitals/facilities are in your
network...there isn't much you can do from
here. in the future you need to contact
your group as they will have a list of
facilities you are in your network. A lot
of people don't understand this part of
their insurance. i think that the nurses
and the people that were checking on your
insurance, may have thought that they
accept your insurance but they are out of
network. some facilities do not accept
certain insurances at all and that is
where the confusion comes in......
so study up on the facilities that are in
your network.
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