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associate, merch, local, creation, beer, kevin dillon, hobbies, drum & bass, dave eggers, chow, alt. rock, mother fucking sons porn, patriot act, kissing, california music promotion, mms, blaxploitation, film, drm, stars, new releases, el desouki, motherson, house, | Hospitals in my little part of heaven are NOTORIOUS for failing to give explanations to their own collection agencies — momand son usually just your name and the $ they would like you to pay. Sometimes, not even the correct address. (I had a client find out about a billing mistake like yours momand son when he went back to the same hospital almost a year later, and was told by the intake worker that he was about to be sued for the past due balance from his previous treatment!) On the other hand — if your plan has a deductible, you may be responsible for paying the whole (adjusted) bill from the hospital. If you don't, they may decide to "undo" the adjustment and come after you for the original amount. |
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If the insurance company is correct, and the negotiated fee is only $460, then the hospital has agreed to accept that amount as payment IN FULL. The house benefit to the hospital is the large number of people in your plan being directed to certain "in-network" providers. If you examine your plan house documents, you'll see a differential between what the plan will pay to "in-network" and "out of network" providers. The industry term is "steerage" — the insurer "steers" its subscribers to a limited set of providers. The theory being that house what the hospitals and docs give up on the front side through discounts, they'll make back in volume. You may be able to explain this to the collection agency — but make sure you have all your documentation in order. |
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