Medical Bill That Was Supposed to Be Submitted by the Hospital to My Health Insurance Company

Question: I have received a letter from a collection agency regarding a medical bill that was supposed to be submitted by the hospital to my health insurance company that would have covered the bill at 80%. The hospital admininstrator called me 3 times to get the insurance information, which I provided; they assured me that this would be taken care. Months later I get this letter. The timeframe to submit bills is 1 year.

Answer: The contract between the insurer and the provider almost certainly prohibits collection from you. Furthermore, the collection agency’s activities may violate the Fair Debt Collection Practices Act. You need to consult an attorney immediately. Meanwhile, send a letter to the collection agency disputing the debt, providing the insurance information, and stating that under the contract between the insurer and the hospital, you are only liable for copayments (which should be collected at the time, not later) and the deductible. If they respond that you are liable, that may be another violation of law.

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