State Childrens Ins Question

[susiestar]

Hi!

Just got a lovely pink notice from the local hospital that my daughter has over $1200 in medication bill not pd since Dec 2002. She has been on Soonercare (OK's medical plan for kids) since before that. Way before that as we are just finishing husband's grad school.

I have placed several calls to have this rebilled to Soonercare. And sent letters, certified, return receipt. The hospital collection agency says that it was denied because not filed with right provider # and now too much time has passed. Soonercare will not pay because it was not billed earlier.

I cannot file the Soonercare as only the provider can. How can I be held accountable when I have no control over what/when they do their paperwork? Can I be forced to pay this?

The hospital and the collection agency both have told me that the errors were the hospitals. They put the wrong # on the form and kept filing it with-o changing it. Now they say I have to pay it all. What can I do about this?

Thanks so much!

Susie

 

[Kim]

No way! They messed up. Their fault.

 

[bigblueagain]

I would first of all call Soonercare and ask for a customer service supervisor. Explain what you have and what has been done. Offer to send copies of all the correspondence. Then ask what she/he can do about this. If you have to, go above her head. Then ask for the claims appeal process. They definitely should have one.There are timely filing limits, and if this is an in network provider, if they did not meet the carriers filing limit, then ask what recourse you have as was THEIR fault not yours. Is this an HMO type product?? If so, there is really no way the hospital can come after you as long as they were in network for the plan. Next I would call the hospital billing office and ask for supervisor there. Do the same as the above. If they give you the run around, ask for her supervisor. KEEEP very good notes of dates and names and times of who you speak with on each call. Let me know what you find out from these and I will guide you thru the next step.
BLUE