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  1. #1
    Join Date
    Oct 2013
    Posts
    1

    Default Patient Was Not Informed by Hospital of an Insurance Denial

    My question involves collection proceedings in the State of: Texas

  2. #2
    Join Date
    Jun 2006
    Location
    Massachusetts
    Posts
    24,521

    Default Re: Patient Not Informed Insurance Denied when Asked Before Admission

    It is Patient's responsibility to know what the insurance will pay for.

    It is also Patient's responsibility to ensure that the insurance actually makes the payment.

    For anything else, we'll need considerably more information.

  3. #3
    Join Date
    Oct 2013
    Posts
    17

    Default Re: Patient Was Not Informed by Hospital of an Insurance Denial

    Was patient not informed of an insurance denial by the patients insurance company?
    They work for you.
    Liability falls back to you if insurance does not pay.

  4. #4
    Join Date
    Apr 2009
    Location
    Somewhere near Canada
    Posts
    35,894

    Default Re: Patient Was Not Informed by Hospital of an Insurance Denial

    Quote Quoting 1Opinion
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    Was patient not informed of an insurance denial by the patients insurance company?
    They work for you.
    Liability falls back to you if insurance does not pay.

    Let's spell it out. It is NOT the responsibility of the insurance company to inform the patient what is or isn't covered; the onus is actually on the patient.

  5. #5
    Join Date
    Oct 2006
    Posts
    16,474

    Default Re: Patient Was Not Informed by Hospital of an Insurance Denial

    Quote Quoting Dogmatique
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    Let's spell it out. It is NOT the responsibility of the insurance company to inform the patient what is or isn't covered; the onus is actually on the patient.
    While I do not disagree...its very questionable, legally if the hospital knew that the insurance was rejected and did not inform the patient.

  6. #6
    Join Date
    Oct 2013
    Posts
    17

    Default Re: Patient Was Not Informed by Hospital of an Insurance Denial

    Quote Quoting llworking
    View Post
    While I do not disagree...its very questionable, legally if the hospital knew that the insurance was rejected and did not inform the patient.
    If I go to the hospital, I follow up with the provider and my insurance company to verify that the bill gets paid. I make sure that there are no surprises. If there are questions, I make sure that they get answered.

    P.S. - I guess you have to get screwed once or know the process in order to be prepared. (most people haven't or don't)

  7. #7
    Join Date
    Jun 2006
    Location
    Massachusetts
    Posts
    24,521

    Default Re: Patient Was Not Informed by Hospital of an Insurance Denial

    Of course, if the poster were to come back and actually provide some information, we could do more than guess.

  8. #8
    Join Date
    Oct 2013
    Posts
    17

    Default Re: Patient Was Not Informed by Hospital of an Insurance Denial

    Quote Quoting llworking
    View Post
    its very questionable, legally if the hospital knew that the insurance was rejected
    The hospital files the insurance........the patient should have more interest in the outcome of the claim since liability falls to them if anything goes wrong.

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