My question involves insurance law for the state of: Virginia
Hello
I had insurance through my graduate school overseas in the West Indies. Their United States contract was with UnitedHealth Care who was their third party insurance here for any services done state side.
When I was in Virginia visiting family, I got very ill and had asthma like symptoms and went to the ER. I went to my Primary care doctor after who referred me to a specialist. My services were given by the specialist in on July 11, 2013. My insurance terminated on July 31, 2013. ALL services were done before this termination date.
Today is July 27, 2015 and about in April of this year, I get a $800.00 bill because my insurance "denied" my claim. After speaking to my insurance, they verified that at the time of service my insurance valid and worked fine because I got many prescriptions from the same "specialist".
I wrote to the medical biller of this, provided my statements from the pharmacy I went to showing my prescriptions from this doctor with insurance, and the emails from my insurance company showing I had active and valid insurance.
It seems now, because the time has gone to process the claim through insurance, they are putting this on me.
Furthermore, I had requested documentation from my profile on the health record from the office, in it, in the notes section, for time stamp 4/24/2014 - this was written "NOTE: Looking at the insurance card this was sent to the wrong insurance so I have added the new insurance to the system and have sent the claim to the correct insurance" (with her initials). Basically the initial claim was sent to the wrong place. It was filed correctly it seems 1 year later.
After being denied, she has contacted the commssioners office citing a complaint against the insurance company for not paying. But she failed to mention that she filed the claim a year after as she herself provided the submission form with the date 2014 in it.
Shes being very rude and nasty with me, constantly sending mail, calling, and hanging up. Ive sent numerous letters to her giving evidence but she is claiming that it is the responsibility of the patient. Right, but its not my responsibility if you screwed up and this is in writing under your initials where the claim is run date is past due the normal 90 day grace period.
What are my options? I am very busy with school and it is hectic as it is....I have not sent her the letter with the proof of her own writing where she has typed up the "error" message. Would this be sufficient?
Please advise. Thanks!
Hello
I had insurance through my graduate school overseas in the West Indies. Their United States contract was with UnitedHealth Care who was their third party insurance here for any services done state side.
When I was in Virginia visiting family, I got very ill and had asthma like symptoms and went to the ER. I went to my Primary care doctor after who referred me to a specialist. My services were given by the specialist in on July 11, 2013. My insurance terminated on July 31, 2013. ALL services were done before this termination date.
Today is July 27, 2015 and about in April of this year, I get a $800.00 bill because my insurance "denied" my claim. After speaking to my insurance, they verified that at the time of service my insurance valid and worked fine because I got many prescriptions from the same "specialist".
I wrote to the medical biller of this, provided my statements from the pharmacy I went to showing my prescriptions from this doctor with insurance, and the emails from my insurance company showing I had active and valid insurance.
It seems now, because the time has gone to process the claim through insurance, they are putting this on me.
Furthermore, I had requested documentation from my profile on the health record from the office, in it, in the notes section, for time stamp 4/24/2014 - this was written "NOTE: Looking at the insurance card this was sent to the wrong insurance so I have added the new insurance to the system and have sent the claim to the correct insurance" (with her initials). Basically the initial claim was sent to the wrong place. It was filed correctly it seems 1 year later.
After being denied, she has contacted the commssioners office citing a complaint against the insurance company for not paying. But she failed to mention that she filed the claim a year after as she herself provided the submission form with the date 2014 in it.
Shes being very rude and nasty with me, constantly sending mail, calling, and hanging up. Ive sent numerous letters to her giving evidence but she is claiming that it is the responsibility of the patient. Right, but its not my responsibility if you screwed up and this is in writing under your initials where the claim is run date is past due the normal 90 day grace period.
What are my options? I am very busy with school and it is hectic as it is....I have not sent her the letter with the proof of her own writing where she has typed up the "error" message. Would this be sufficient?
Please advise. Thanks!
Health Insurance: Health Insurance Claim Denial (Urgent)
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