Newarcher Posted February 28, 2006 Report Share Posted February 28, 2006 I hate to post something like this in a forum but I just murdered someone in a fit of road rage and need help.... JUST KIDDING. I took my son to a local ER for treatment 7/30/2005. I received two billls...one from the hospital and one for the ER doctors. I paid the hospital bill under my deductible. The ER doctor's bill of $130 is distributed as follows by my insurance company: $64.50 negotiated provider discount, $15.00 copay (which I paid) and $50.50 paid by my insurance company. Despite repeated arguments that I am not responsible for the provider's discount amount----they are saying that they aren't a member of my insurance network. However, my contract clearly says that if you are working for a hospital that is part of the network, you will be paid network prices. The responsibility for payment lies between the hospital and their doctors...I don't care who eats it. If you accept a contract as the hospital, you are responsbile to see that any doctors who contract with you adhere to that contract. If your contract with the doctors doesn't say they have to take the $64.50 discount on that procedure, then you as the hospital have to eat it. If it does, the doctors have to eat it. Pretty simple huh? Nah, yesterday I received a collections letter from them. It might be a real collections agency or one of those psedo collections agencies that are nothing more than the billing people at the doctor's office pretending to be a collections agencys. But, the agency is in a different state so it looks real. Both myself and the insurance company have fulfilled everything that I we are supposed to pay. The responsiblity lies somewhere between the hospital and the doctor's office. If this hurts my credit, I will find an attorney and go after them with every vengeance I have. My contract says I pay $15 copay for an ER visit. That's it. I don't owe this but I am the one in collections. Right? New Quote Link to comment Share on other sites More sharing options...
rifleman25 Posted February 28, 2006 Report Share Posted February 28, 2006 Re: Any lawyers out there? My wife is an attorney. I'm sorry to hear about this Quote Link to comment Share on other sites More sharing options...
VtBowhunter Posted February 28, 2006 Report Share Posted February 28, 2006 Re: Any lawyers out there? New, you need to take that contract down to the billing dept. of the hospital and show it to them along with your reciept of payment for the copay. Quote Link to comment Share on other sites More sharing options...
MrWiggely Posted February 28, 2006 Report Share Posted February 28, 2006 Re: Any lawyers out there? I have had the samething happen. The response from my attorney at the time was that the Dr. was an independant contractor for the most part and not working for the hospital. He perfomed services there. I ended up paying the difference because of that. The hospital billed me for the er, operating room and supplies, and the Dr. billed me for his services rendered. I hope you make out better than I did. Wigs Quote Link to comment Share on other sites More sharing options...
Newarcher Posted February 28, 2006 Author Report Share Posted February 28, 2006 Re: Any lawyers out there? I think your attorney gave you bad advice. Most doctors contract with the hospitals and while independent contractors still answer to the hospital and vice versa. If that was the case, a hospital could never be sued if a doctor operated drunk. Likewise, the doctor couldn't be sued if the hospital failed to sterlize equipment. The bills are definitely different and separate but when your insurance carrier contracts with the hospital, that must flow through to the doctors as well. If not, you could go to the hospital that is part of your HMO plan and get an appendectomy. Then the anesthesiologist and the ER physician and the surgeon could each charge $1,000,000 each--despite your contract saying that you only owe a $20 co-pay for surgeries. That is the reason for your 200 page disclaimer book you have to sign. New Quote Link to comment Share on other sites More sharing options...
Hoosierbuck Posted February 28, 2006 Report Share Posted February 28, 2006 Re: Any lawyers out there? I don't practice in civil litigation because of this kind of gabage. When it comes time to put someone in prison, then call me. You seem to have it covered pretty well, New, good luck. HB Quote Link to comment Share on other sites More sharing options...
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