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  1. #1
    Join Date
    Jun 2014
    Posts
    5

    Cool Summons for Unpaid Medical Bills

    My question involves collection proceedings in the State of: Kansas
    I went to a local clinic for my prenatal appointments starting in late 2012. I was insured on my own until March of 2013 then I was married and got on his insurance plan. The clinic has been very difficult to deal with when it came to paying my bill with them. I was making payments of $65 a month for most of my pregnancy for just misc. appointments and a pair of glasses on my account. I assumed that because they weren't billing me for my prenatal appointments that my insurance was paying for them. However after I came home from the hospital after delivering my son I received a bill from the clinic in the mail. Suddenly, I owed them well over $2,000 for my prenatal care. They explained it was policy to not bill for any of those services until I had delivered.

    My husband lost his job a few months after my son was born so we are now on a new insurance policy. Is there anyway to tell if the old insurance company paid what they should have? I don't have a copy of our insurance plan so I can't be sure that they didn't pay properly. However, I know I hit my deductible between the hospital stay and the prenatal appointments. I have tried to look into but had no success. Now it has become increasingly important to get some answers because I was sent to collections and now they have summoned me to be judged in court in a month.

    I tried to make payments to the clinic but they refused to take my $65 a month but I couldn't afford what they wanted (more than double). Finally they sent me to collections and I offered to pay somewhere around $50 a month. The collection agency said they would get back with me about making payments instead they are sending me to court. I spoke to them today and they agreed to a payment plan but they said they are still going to take me to court for judgement. I have so many questions. I am wondering is there anything I can do? Why are they taking me to court still even though they agreed to payments? Can the clinic pull it back out of collections at this point if I make payment arrangements? Lastly, Is there anyway to tell if the insurance owes more than what they paid?

  2. #2
    Join Date
    Apr 2009
    Location
    Somewhere near Canada
    Posts
    35,894

    Default Re: Summons for Unpaid Medical Bills

    Call them and ask, and get your husband to ask for an EOB (explanation of benefits) from the original and the new providers.

    Unfortunately they're not obliged to accept your offer of payment and they're within their rights to take further action.

    Stand by for others to stop by.

  3. #3
    Join Date
    Jun 2006
    Location
    Massachusetts
    Posts
    24,521

    Default Re: Summons for Unpaid Medical Bills

    I assumed that because they weren't billing me for my prenatal appointments that my insurance was paying for them.

    First mistake. Never assume. If you're not getting billed, ASK.

    When you called the insurance company that was in place during your pregnancy and asked them if the bills were submitted and paid, what did they say?

  4. #4
    Join Date
    Jun 2014
    Posts
    5

    Default Re: Summons for Unpaid Medical Bills

    They didn't really answer any of my questions they just sent me some papers in the mail showing some of what they paid. I spoke to the clinic and they said most of the bills had been submitted to the insurance company. However, there were a few appointments they failed to send through insurance so they resubmitted them. My insurance did pay some but I believe they didn't pay what they should have. I am just not sure what my next step should be with this judgement coming up.

  5. #5
    Join Date
    Jun 2006
    Location
    Massachusetts
    Posts
    24,521

    Default Re: Summons for Unpaid Medical Bills

    Okay, I'll bite.

    Why do you believe they didn't pay what they should have? What do you believe they should have paid?

  6. #6
    Join Date
    Jun 2014
    Posts
    5

    Default Re: Summons for Unpaid Medical Bills

    I am not as worried about the insurance now, I am more worried that my husband will have his wages garnished. The reason I believe they didn't pay their portion is: I hit my deductible before I even went into labor because I was only supposed to pay a copay for my regular checkups but they charged me more than that. After hitting my deductible it was supposed to be they pay 80, I pay 20. I paid well over 20% and they paid well under 80%.

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

    Default Re: Summons for Unpaid Medical Bills

    I'm almost certain I know the answer to that but let me ask you a couple questions.

    Was this a managed care plan? HMO, POS or PPO?

    If a POS or PPO, was the provider in-network?

  8. #8
    Join Date
    Jun 2014
    Posts
    5

    Default Re: Summons for Unpaid Medical Bills

    I am honestly not sure the answer to that but I believe it was PPO. The provider was in-network, we only have one clinic here in town and they are considered in network.

  9. #9
    Join Date
    Jun 2006
    Location
    Massachusetts
    Posts
    24,521

    Default Re: Summons for Unpaid Medical Bills

    Considered in-network by whom? Did you confirm that your policy considered them in network?

    I'm not trying to give you a hard time; I'm going somewhere specific with this.

  10. #10
    Join Date
    Jun 2014
    Posts
    5

    Default Re: Summons for Unpaid Medical Bills

    I totally understand. I will go back and look again to make sure I wasn't mistaken. However, they were in-network from what I recall.

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