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  1. #11
    Join Date
    Dec 2013
    Posts
    3

    Default Re: Dispute Between Provider and Insurance Comapny

    So what you are saying that the responsibility falls on me completely and although the monitor company called and assured me that I am covered 100%, I will now have to bear the consequences. I feel cheated. Although legally it may be fault, isn't there anything I can do at this point? I don't even think I can pay $7,200 at this time. What do I do? Will they reduce the amount? If I dispute the claim, will that give me time before they send collection my way?

  2. #12
    Join Date
    Mar 2013
    Posts
    18,340

    Default Re: Dispute Between Provider and Insurance Comapny

    Quote Quoting rebech34
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    So what you are saying that the responsibility falls on me completely
    Between you and the insurance company, yes, because that's what the policy says.

    Quote Quoting rebech34
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    although the monitor company called and assured me that I am covered 100%, I will now have to bear the consequences.
    You have the option of suing the monitor company for a declaratory judgment that you don't owe the money because the company rep defrauded you by assuring you that you were covered 100%. But do you know what the first thing is that the judge will ask you? It's "did you verify that with your insurance company?"

    Quote Quoting rebech34
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    I feel cheated.
    Again, can you prove (not just say) that the company cheated you?

    Quote Quoting rebech34
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    Although legally it may be fault, isn't there anything I can do at this point? I don't even think I can pay $7,200 at this time. What do I do? Will they reduce the amount? If I dispute the claim, will that give me time before they send collection my way?
    Unfortunately, where most people make their mistake is they believe the disputing the debt involves only saying that they don't owe it while refusing to pay. That kind of thing falls on deaf ears and goes right to the collection agency.

    If you can't pay the $7,200 ask for a payment plan. But if you want to reduce the debt, offer cash in a reduced amount as a lump sum settlement. The medical profession does that all the time so that they can get a large amount of money now instead of dribs and drabs over time. Just make sure you aren't offering chump change. At least 50% or better ought to do it. And make sure you get a written agreement from the provider that the settlement is paid in full and the balance waived.

  3. #13
    Join Date
    Sep 2011
    Location
    OH10
    Posts
    17,019

    Default Re: Dispute Between Provider and Insurance Comapny

    I would talk to the person who is in charge of obtaining authorizations. I had a recent situation where the insurance company changed their procedures and I had a surgery before the doctors office was aware. They waived their fee and the hospital also waived theirs for that surgery. Saved me $4500 out of pocket.

  4. #14
    Join Date
    Sep 2005
    Location
    Behind a Desk
    Posts
    98,846

    Default Re: Dispute Between Provider and Insurance Comapny

    Quote Quoting Disagreeable
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    I would talk to the person who is in charge of obtaining authorizations.
    Absolutely. Find out how the mistake occurred and what they're willing to do for you.

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