My question involves insurance law for the state of: New York
A rehab sued to collect money for part of mom’s stay. The last 6 months mom was there, although all 6 were approved & 1 out of the 6 months was paid in full by error, her days of coverage expired under her private primary insurance. We weren’t aware til 2 months post discharge. Instead of dealing with provider services to recover payment, Medicare was retroactively billed leaving us around $11,000 in co-insurance charges. The lawsuit then increased as the primary insurance requested reimbursement for the month paid in error. On another instance 3 months prior to the dates of the suit, the primary stated $16,119.27 was paid, but only wrote a check for $4,464. Instead of recovering the difference, again Medicare was billed when they shouldn’t have been. This effected the 20 day co-insurance grace period factored into the settlement amount. I spoke with a supervisor at the primary insurance company who saw all the pre-approvals & stated it was their responsibility to pay what was approved, regardless of date last insured. They issued a check for over $43,000 to cover the cost of approved, not paid by the primary & ultimately paid by Medicare. There’s now around $30,000 in double payments! No need for this lawsuit! Had the insurance not mistakenly approved 6 months & miscalculated payment for another month, the problems wouldn’t have started. Had the nursing home contacted provider services to collect the money, there would be no suit! I straightened this entire matter out doing something they should have done 2 years ago! Do I have grounds to request reimbursement of my $3,000 attorney fee?