Expert: Merry Schiff - 6/25/2008

Question
QUESTION: My daughter was 20 years when she gave birth. At that time, she was covered under our health insurance but the newborn was not because he is not our dependent. The pediatrician who administered the newborn check in the hospital has sent my husband to collections for the bill denied by insurance because the child is not our dependent. The "patient" being billed is my husband. He was not the patient. Are we responsible for this bill?

ANSWER: Your husband should not be responsible for the bill but because your daughter was on your insurance, I imagine that the physician just assumed that you  were responsible according to the face sheet from the hospital. But, if you were sent to collections, they obviously tried to reach you,  I would hope,  about the bill. Did you tell them that you were not the guarantor. Someone may have signed something at the hospital saying that your husband, who I assumed holds the insurance, was the guarantor. Another question..who paid for the hospital care for the newborn?

These things can get confusing. I would first see what is on the records at the hospital because that is where the pediatrician got the information about billing.

Has there been no communication between you and the pediatrician's office?

Sadly, there are people working in offices that do not do their job well. So, the first thing you need to do is see what the paperwork says at the hospital. And a clue would be who paid for the newborn care at the hospital because it is a separate charge from the delivery.

Please follow up with me and tell me what you find out. And you can request a copy of all the papers signed at the hospital.

Merry

---------- FOLLOW-UP ----------

QUESTION: Yes, I spoke to the pediatrician's office on the phone and sent a letter saying we are not responsible for this bill. Obviously, they did not want to hear it. As for the newborn charge, that is what they are trying to bill us for. We could not add our grandson to the policy because we are not his legal guardian. Thank you for the information so far.

ANSWER: But did the hospital get paid for newborn nursery? Please find out and let me know.
You need to send a letter to the office and to the collection agency and dispute this. I would also see if this is on your credit report and if it is dispute the charge. Please follow up with me.

Merry

---------- FOLLOW-UP ----------

QUESTION: Merry,

I contacted the hospital and they were of no help. They won't give me any information pertaining my daughter's care/billing due to HIPPA. The billing office did tell me that they would assume my daughter would have had to sign any paperwork assuming responsibility. Now, the hospital must have been paid for the newborn charges. However, I can't find a separate charge on my insurance for just the newborn. I wonder if the newborn care was listed with my daughter's care in the hospital. Do you think that is possible?

I am going to send the doctor's office another request to pull this account out of collections and send the collection agency a letter disputing this charge.

What do you think?  

Answer
Your doctor is handling this improperly. I would send a certified letter return receipt (doctor only) and tell him that this was inappropriately billed and that if it is not pulled out of collection, then you will report this to the appropriate board that handles complaints against doctors. Whee is your daughter in this? Has she called the office and told them that she is responsible? I would also copy the letter that you send to the collection agency and to your daughter.  I would like to think that this is being handled by the staff and that he has no knowledge..hopefully anyway. The dr is responsible for whatever his staff does.

If you need help with the letter, just let me know. And please mark this private so that we do not clutter up the board with this situation.

Merry