What should I do?A hospital lied that they are contracted w/my insurance..but NOT! Now they are asking me $$

Question

I had a surgery last year. When I went there, they told me the surgery will cost $3000. I asked them if they are contracted w/ my insurance. They told me " Yes we're contracted, and the bill will be covered 80%." So I had surgery and we paid $1000 at the hospital as a deposit. 6 month after the surgery, I received EOB from my health insurance company....."WHAT??" Nothing was covered....I called the hospital several times, and all they say is, "We did not say that! We are not contracted w/ any insurance company." I understand that I should have called my insurance company first to make sure that they are contracted before surgery...but, is there anything I can do now? ? ? Please help!

Answer 1

There is nothing you can do at this point.  You are correct, in that the place to call for confirmation was the insurer and not the hospital.  Even if the hospital DID tell you that, they are not responsible for that error.  You had the surgery, and you are responsible for the charges involved.

Expensive lesson the learn, sad to say.

Answer 2

it was your responsibility to check your insurance coverage.  Work out a payment plan with the hospital and pay for your surgery.

Answer 3

Ultimately it is your responsibility to choose a network hospital and verify the status with your insurer.  So, its unlikely you'll be able to get your insurer to pay any additional money.

You may be able to work out a financial arrangement with the hospital though.  That's the angle I would take.

Answer 4

honestly, no.

ultimately, as you know, it is YOUR responsibility to call your insurance company and verify a providers status before services are rendered.

the only thing you really could do (but it might not work to your liking) is file an appeal for additional payment through your insurance and let them know what happen. they may make a one time exception, they may not.

Answer 5

Well, it's not up to the hospital to be sure that they are contracted with your insurance - it's up to you.  Some insurance companies, and particularly health "plans" that aren't insurance, know that, and deliberately pick names that sound like some of the major players, knowing that when you ask, the person at the hospital will most likely, unknowingly, give you the wrong information.

You have to call the insurance.   You can always file an appeal with your insurance company, but if the hospital is now telling you they have NO contracts, you're likely going to lose.

Answer 6

I find that hard to believe that a hospital wouldn't take ANY insurance - they'd never get enough patients to survive - check back with your insurance company - maybe some info was submitted incorrectly