Sunday, March 6, 2011

If health insurance is refusing to pay for something they should, is the patient ultimately liable?

Would this be a matter directly between the hospital and the insurance company? Or is this a matter where the hospital holds the patient liable, and the patient holds insurance company liable? Thanks for the help.
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Yes, you will have to pay the charges if the insurance company does not pay. The insurance company always says no to any charge that is not routine. You need to follow the dispute procedure outlined in your policy. You can call your insurance agent if you have one, or call the information line for your insurance company. The hospital isn't going to fight for you. You need to do this yourself. If the insurance company still won't pay for the procedure after you go through their entire dispute process and you are certain that it was a covered event, you can sue your insurance company.
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