PLEASE HELP! Being told I owe $7,400 after insurance for ER visit [NV] Desperate and broke.

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I have a high-deductible insurance with a ded of $1,500 and out of pocket max $3,900. I’m currently unemployed and have had a $0 income since October 2020. Age 27 zip code 89501.

Here is the timeline:

Jan. 2, 2020 I go to the ER as recommended by a doctor. I got a CAT Scan, Ibuprofen, a prescription, and a diagnosis. In and out in less than 2 hours.

One month later I get billed for radiology, I pay $634 (insurance covered 0% and this went to my deductible). I also got billed by the doctor and I payed $1,193 (insurance covered 25% of total cost and that was the remaining balance I payed towards my deductible).

In May, I get billed like $200 from the ER (payed immediately) and was under the impression that my ER fees were over with and I no longer owed anything. I got this impression because on my insurance portal where I can see how much money I owe towards medical expenses it said ZERO DOLLARS OWED. Also, in my insurance portal when I view all of my claims in a list, under the specific claim for billing from the hospital it says patient responsible for $0.00.

Now it’s December and I get a letter from collections saying I owe $7,401 and I have 30 days to pay it.

My insurance said they only rework or appeal claims up to a year after date of service. I then had only 3 weeks to resolve it.

I was never given a bill, notification, or anything that said I owed this much money to the hospital. I called the hospital and they said the reason is that my insurance first processed the visit as in-network and then months later, decided it was out of network and told me I am responsible for the remaining balance. My plan is a high-deductible plan with a deductible of $1,500 and out of pocket max of $3,900. After paying my hospital expenses including the $200 for the ER visit, I had reached the max deductible and my insurance was supposed to cover 80% of the charges at that point.

I talked to the insurance and they said that the hospital was too expensive and it went past the “allowable” amount. The insurance said that they would only cover up to $1,200 of the entire $8,600 bill. Nowhere did I see an asterisks next to the “you pay 20% out of pocket for out of network after reaching the deductible amount” that said up to an allowable amount.

I talked to the creditor and she said something fishy is going on. Insurance won’t budge and hospital billing people are being completely rude and one told me “maybe you could get a loan” to pay off my medical bills. Hospital said I can’t apply for charity since I had insurance then.

submitted by /u/Mami-punani
[link] [comments]
I have a high-deductible insurance with a ded of $1,500 and out of pocket max $3,900. I’m currently unemployed and have had a $0 income since October 2020. Age 27 zip code 89501. Here is the timeline: Jan. 2, 2020 I go to the ER as recommended by a doctor. I got a CAT Scan, Ibuprofen, a prescription, and a diagnosis. In and out in less than 2 hours. One month later I get billed for radiology, I pay $634 (insurance covered 0% and this went to my deductible). I also got billed by the doctor and I payed $1,193 (insurance covered 25% of total cost and that was the remaining balance I payed towards my deductible). In May, I get billed like $200 from the ER (payed immediately) and was under the impression that my ER fees were over with and I no longer owed anything. I got this impression because on my insurance portal where I can see how much money I owe towards medical expenses it said ZERO DOLLARS OWED. Also, in my insurance portal when I view all of my claims in a list, under the specific claim for billing from the hospital it says patient responsible for $0.00. Now it’s December and I get a letter from collections saying I owe $7,401 and I have 30 days to pay it. My insurance said they only rework or appeal claims up to a year after date of service. I then had only 3 weeks to resolve it. I was never given a bill, notification, or anything that said I owed this much money to the hospital. I called the hospital and they said the reason is that my insurance first processed the visit as in-network and then months later, decided it was out of network and told me I am responsible for the remaining balance. My plan is a high-deductible plan with a deductible of $1,500 and out of pocket max of $3,900. After paying my hospital expenses including the $200 for the ER visit, I had reached the max deductible and my insurance was supposed to cover 80% of the charges at that point. I talked to the insurance and they said that the hospital was too expensive and it went past the “allowable” amount. The insurance said that they would only cover up to $1,200 of the entire $8,600 bill. Nowhere did I see an asterisks next to the “you pay 20% out of pocket for out of network after reaching the deductible amount” that said up to an allowable amount. I talked to the creditor and she said something fishy is going on. Insurance won’t budge and hospital billing people are being completely rude and one told me “maybe you could get a loan” to pay off my medical bills. Hospital said I can’t apply for charity since I had insurance then.
submitted by /u/Mami-punani [link] [comments]Read Morer/HealthInsurance

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