Can a Tennessee hospital refuse to bill your insurance company and bill you instead?
A Tennessee hospital refused to bill my insurance company and attached a lien to my settlement for the full amount of the bill. They would have got a discount rate if they billed the insurance company.
Tags: Bill, Company, hospital, instead, Insurance, Insurance Company, refuse, Tennessee
If the hospital is not a member of the insurers network, they are billing you since they don’t want the discount rate, they want the full payment. You are expected in turn to submit the claim to your insurance company.
Assuming you went out-of-network, it is likely that you will only be covered for 60 to 70% of the bill and expected to pay the difference.
However, if the hospital is in your insurers network, you need to complain to your insurer. This is deemed balance billing and is usually against the contract and/or state law.
“Tennessee hospital refused to bill my insurance company ” Most do bill insurance because it is the easiest way to get paid. They do this a a service and it isn’t required. This is likely clearly stated in the paperwork you signed.
“attached a lien to my settlement ” So they won a judgment against you? What did you state in court? Why didn’t you pursue the insurance claim? What settlement? When a settlement is reached, you insurance company may be entitled to any fees awarded for medical costs anyway. Either way it should work out the same way.
“They would have got a discount rate if they billed the insurance company” They would have had to accept a discount rate as a part of their agreement to accept that insurance. Many hospitals have quit accepting certain types of insurance for that reason. The insurance doesn’t want to pay enough to cover cost. The hospital looses money in that case.
It sounds like your gripe should be with the insurance company and not the hospital.
Yes. No medical provider EVER has to bill your insurance. And if you’re asking them to bill an insurance company that is not THEIR “in network” health insurance company, they have even LESS duty to do it.
Most of the time, though, they WILL bill your HEALTH insurance. They will most of the time bill workers comp. They rarely will bill an auto insurance policy. Since you’re talking about a lein on a settlement, I”m guessing that you wanted them to bill someone ELSE’S auto insurance policy, which is flat out impossible.
And, your settlement amount INCLUDES medical bills, AND, the other person’s insurance will NEVER issue a partial medical bill payment before the claim is entirely settled. Your attorney submitted the medical bills in full – so if you want YOUR payout based on the full amount, it’s only fair that the hospital also gets paid the full amount.
Can’t have your cake and eat it, too.
I suspect there is much more to the story than you include here. Too many details and specifics are missing.