My question involves insurance law for the state of: PA
Two years ago I was went to my local hospital with chest pains. I was stabilized and ambulanced to another hospital with cardiac care where I received a stent implant. I was insured by Medicare as primary and BCBS secondary. All providers were paid by Medicare but the doctor group at the second hospital. They claim they received a payment from BCBS but it was later rescinded and Medicare refused to pay. (I have yet to see any paperwork on this). Medicare and BCBS both state that the provider never billed them. The provider turned the bill over to a collection agency who now threatens to file suit. The provider in question is a participating provider.
I only learned of this recently when I requested a copy of my credit report. I called both Medicare and BCBS both insist they never received a bill from this provider and therefore no EOB's. The medical provider has promised to sent me copies of the EOB's but claims they must have been lost in the mail. I am awaiting another set of copies.
I realize this is a confused issue but I would like to hear comments.