How can I make a hospital stop billing me due to their mistake?

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How can I make a hospital stop billing me due to their mistake?

My insurance company approved a diagnostic procedure for my hospital. My hospital performed a different, more expensive procedure, which my insurance refused to cover. The hospital is now billing me full-price for the unapproved procedure. My insurance carrier says based on their agreement with the hospital, I’m only responsible for the co-pay. What is my legal recourse to settle this matter?

Asked on August 16, 2011 Oklahoma

Answers:

FreeAdvice Contributing Attorney / FreeAdvice Contributing Attorney

Answered 10 years ago | Contributor

You need to obtain documentation from your medical insurance carrier stating clearly that based upon its agreement with the hospital where you had the procedure that you are only responsible for the "co-pay" amount.

Assuming you get this document from your health insured and that you have paid the "co-pay" amount, send a copy of this document to the hospital's accounts receivables office requesting that you be immediately contacted to resolve the issue on the invoice claimed to be owing. Copy your health insurer on the letter and keep a copy for your future need.

At this point, it is very important for you to set forth your position on the subject with documentation supporting it.

Good luck.


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