Legal term or act for getting the itemized medical bill as hospital is denying to provide the one?

Question

Received a bill from hospital for Maternity and Delivery charges which has a lump sum amount ( $800) under patients responsibility section stating as the deductible, but that whole amount is not covered under my deductible. My deductible is only $500. When I called the hospital billing department( which is 3rd party that maintain their billing) told me that they can not give me the itemized bill. They said they have this rule ( in aggreement with all the insurance companies) to send such bills and they cannot provide me the itemized bill.

They said that the remaining $300 is your copay. but I need the itmeized bill for my copay? Is it not my right to get the itemized bill .Does anyone know if there is any consitutional act or legal term to get the itemized bill so that I can refer that same name/act in my letter to the hospital

Answer 1

The hospital must supply you with an itemized statement.  They don't have to supply the HCFA used to submit the claim to your insurance, but they must supply you with an itemized total upon request.

Answer 2

it varies in different, but where i am there is no problem getting an itemized bill, have you talked to your insurance company or just the hospital? there really isnt a legal term that im aware of ( am a medical biller), best bet would be to call the ins. and talk to a supervisor, also double check your policy and pay attention to small print! good luck

Answer 3

You are most certainly entitled to a copy of the itemized bill.  After all, that's the Hospital's list of the exact services and supplies that were provided to you; and if the Hospital wants you to pay, they have to demonstrate what you owe.  Ask to speak with a Manager and tell him/her what you were told, so s/he can deal with this incorrect employee -- and provide you with this information.

You also need to contact your insurer and ask how much you owe.  This should also be reflected on the EOB's you should have gotten.

If you have further trouble, contact your state's Consumer Protection Division.  Most have sections that help consumers deal with situations like this.  (FYI, your insurance commissioner's office won't have authority, since insurance laws don't regulate hospitals.)

Answer 4

They are lying  to you.  You are  entitled to an itemized bill.

Find out who the Dept. manager is and send a certified letter to this person demanding an itemized bill.  Also, follow up with a phone call.  If this person does not respoond in a timely manner, send a certified letter to the hospital's administrator.  (The administrator's job is too make you, the customer, very happy.)  Administrator's earn a very good salary and they want you to be happy.

Good  luck.