Re: Medical bills and insurance

Posted by Lee (12.213.86.162) on March 01, 2003 at 14:11:08:

In Reply to: Validation and collecting from multiple people? posted by Monica on March 01, 2003 at 11:31:26:

In what state were the medical bills incurred, and was it the same state where you lived? You mentioned insurance - was it an HMO or PPO? If insurance authorized the treatment, most states have laws preventing collections on covered expenses even if the insurance did not pay. (Your mother would be responsible for non-authorized services and co-insurance amounts.) In Calif, the fine is $10,000 and up to 1 year prison for each offense. The medical provider is also responsible for the actions of the CA.

I worked a case last month where a surgeon was under contract for discounted rates with a mini-HMO, and returned their payments 4 years ago because he wanted to be paid the full billed amount from the patient's expected personal injury settlement. Doctor sued patient, so we informed that wasn't legal. Doctor is SOL, because the mini-HMO went bankrupt 3 years ago.

I recommend contacting the insurer. In many cases, they can clarify the issues.

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