Resolving Late or Unpaid Health Insurance Hospital Bills
Part 2, Chapter 5: Traditional Individual and Group Plans, Hospital Bills Page 8
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Since the bill had already been paid in full as far as the hospital was concerned, the hospital apparently assumed that the check was a duplicate sent in error and returned it to the insurance company. It took a number of months to resolve the problem. This case represents a good illustration of the need to allow both primary and secondary insurers to fully process hospital claims before paying the remaining balance.
However, until your insurance company pays the bill, you may receive bills or letters from the hospital requesting immediate payment. Those may be computer-generated messages, and should not be taken personally. If your insurer does not pay the bill within a reasonable period of time, you will need to respond to those notices. At that point, you'll need to work with the hospital billing office and the insurer to identify and correct the problem.
If your insurer does not pay the bill quickly, file an immediate claim appeal with the insurance company. It's important to deal with an unpaid hospital bill before the hospital turns the matter over to a collection agency, since that can produce unnecessary complications. If your insurer does not pay the hospital bill -- even after you've filed a claim appeal -- and you receive a letter from the hospital suggesting that they are planning to turn the bill over to a collection agency, it's essential to respond immediately and to talk with the hospital billing office and with your insurer to try to resolve the problem. (See Chapter 3 for information on resolving claims problems.) If you need additional help, you can consult an appropriate state or federal agency, your county or state medical society, a private claim-processing company, or an attorney.
Once your primary and secondary insurer have fully processed the claim and have provided the appropriate reimbursement for the hospital bill, it's important to pay any remaining balance quickly. In addition to co-payments, that balance may include expenses related to the use of a telephone, the cost of a television rental, and similar expenses that are not usually covered by health insurance policies.
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