Health insurance question (specific)

[akafred]

PDQ, will DD at least the details.

As you guys may know, I was in a serious accident in January where a drunk driver hit me head on. All the bills including chiro are finally available and I am trying to settle with his insurance. Unfortunately he had state minimum coverage so I am capped at that amount. My medical bills are thankfully less than that, so I get *something* for pain and suffering. I have no real desire to sue the ahole who hit me or the idiot who loaned him her car and didn't have insurance. (I may have to for DD, but that is another story). I think collecting beyond the coverage would be an issue even if I got a judgment.

Here is where it gets tricky. The hospital bill total is for $8300, and they put a lien against the insurance claim for that amount. There is one more lien for $1400 for my MRI. They did this automatically vs waiting for me to not pay or whatever. The $1400 one is no problem. However I got a "Final Notice" bill from the hospital in the amount of $1900. I have confirmed that the $1900 is the adjusted amount after my health insurance. Since I am a BCBS customer, their negotiated rate is $1900, not $8300. Presumably from what people are saying, BCBS didn't pay the $1900 because of my deductible. So the hospital billed me and my insurance AND put a lien on the claim for the same services. (This is not a hospital vs ER doctors having 2 bills thing; I have a third bill from the ER docs also. It is definitely $8300 broken up into the $1900 contracted rate and $6400 adjustment per contract). When I call the hospital, all they are looking for is $1900. But when the insurance company cuts me a check, they will also cut the hospital a check for $8300 (and the other lienholder their check).

What I would LIKE to happen is obviously to pay the $1900 and have the hospital lift the lien, and the insurance company pay me the full amount less the other lien. Right now I informed the insurance guy that we need to wait for this to be resolved; the hospital has it in review status but it may take a few weeks. Meanwhile the insurance guy is an ahole and demanding too much info.

Anyone have any experience with anything like this? What can I expect? I'm trying to avoid overpaying. Of course I would love to underpay lol, but even if the full $8300 gets paid it isn't the end of the world. I would like to avoid having to chase the hospital for the money though.

[shakinros]

Oy. I don't have any experience with this but just wanted to comment in support. I hope this gets resolved positively for you.

[k3am]

akafred, it may be worth speaking with an accident/injury attorney. Around here they do a free consultation and you don't pay if you don't win. At least according to the billboard ads. But they may have some advice/suggestions on how to handle this.

[akafred]

Sept 27, 2017 9:33:02 GMT -5 k3am said:

akafred, it may be worth speaking with an accident/injury attorney. Around here they do a free consultation and you don't pay if you don't win. At least according to the billboard ads. But they may have some advice/suggestions on how to handle this.

They take 33% of your total settlement and I am capped at a certain amount (unless I go to court and then I can't collect against a deadbeat anyway). If I gave them 33% of the capped amount I will be out of pocket and have $0 for pain and suffering.

[mustardseed2007]

Just from my experience, the hospital can and will eventually reduce their lien to the amount of the actual bill, although you will need to insist on it.

Your health insurance should have no right to information from you because they paid nothing due to your deductible amount.

I would require that the hospital reduce the lien to the amount of the bill before you either pay it yourself or have the insurance company cut you a check that can be used to pay it.

[waverly]

I think I would ask the auto insurance company to pay you directly rather than pay the hospital.

I don't really like the idea of you paying the 1900 though until you get the 8300 check. Because what if the auto insurance company comes back and says the bill is only 1900, so that is what we will pay?

Can you stave off the hospital for a while so they don't attempt to put it into collections?

[xctsclrx]

Disclaimer* Not in insurance and it confuses me.

I think your insurance wants to be paid anything that they put into it. Since they didn't pay anything I would be tempted to leave your insurance out of it. Let that 1900 or 3300? go to your deductible and when you get your settlement check pocket it. Can you pay the bill so that nothing happens to your credit?

If not then wait for his insurance to pay out, but make sure the hospital doesn't send your bill to collections. His insurance should be paying the 8300 bill and then your hospital should give you the rest of the balance. My hospital only took 2 weeks to cut me a check so it shouldn't be too hard.

To make 100% sure though I would actually talk to a patient representative at the hospital and ask for the procedures in dealing with car accidents such as this one. They see this more that an insurance rep on a phone does, and they know the ends and outs of their hospital. Plus also in town so if you need to you can go in person if needed.

[akafred]

Yeah the hospital put the bill in "review" status so they said that means it won't go to collections. And I agree, I don't want to pay the $1900 until the lien is resolved because then I could be out $10000+ total and have to push the hospital for a refund, which could be an even bigger mess.