AboutTricia Expertise Has your medical insurance company denied your claim and refuses to pay? Have
you received a pre-authorization and still your insurance company
refuses to pay? How can you get your insurance company to reverse a
denied claim? How do you get a provider to waive your copayment if you
are financially unable to pay? Can a provider sue you for a unpaid bill and
will they? Can a provider send me to a collection agency for a medical bill?
If my insurance company does not pay, am I responsible? If you have these questions or others on why your insurance company is not paying your bills, I can help. I can give you "tricks of the trade" to get your insurance company to pay.
I have limited knowledge on Medicare and Medicaid and that is not my expertise. Each state is very different regarding Medicare and Medicaid so you need to review their website when you have questions. So please no Medicare or Medicaid questions!!
Experience In the medical field for over 20 years spending majority of time in the collections aspect.
I am currently 7 months pregnant, and I am using my out of network benefits to cover the costs. My insurance covers 70%, I have met my deductiable. I have not been recieving any medical bills from the hospital I am going to for prenatal care, I called the outpatient billing department at the hospital and I asked if I owe any money and they said "no" in response, that they are getting paid. I did let my provider know that I am using out of network benefits, can it still be possible to recieve a "mountain" of bills afterwards, I am very nervous I am biting more than I can chew.
Answer Hi Tiffany!
If your out of network benefits is 70/30 then you probably will receive a bill for your portion as the bills get paid.
The only way not to is if the hospital is accepting your out of network benefits as if they are in network....which is probably highly unlikely.
To check call your insurance company or go on line....most insurance companies have websites where you can view every bill and see if you are liable for any balances.
