My wife and I had a baby in August 2020 and sometime in October we got a bill that was for Nursery 2 and was billing us about 10k split between me and my health insurance (so 5k each). I called the hospital multiple times as it seemed that they were billing us incorrectly/too much as my son was not born pre-mature and that the maximum that they could charge was like $1,200 a day for Nursery 2. After a few weeks of calling non-stop and then them threatening to send the bill to claim, I finally decided to pay the bill as we didn’t want our credit to be messed up.
In the middle of January, I get a notice from Aetna stating that bill has been revised, and now the total is 4k (2k to be paid by my insurance and by me). I call up the hospital who agrees and says a check will be sent in 6-8 weeks. After 8 weeks I call and they tell me it never went out and to wait another 8 weeks as the director is now signing off on it. Mid-April I call them again to ask about my refund and they state they are now disputing Aetna’s updated claim. I then call Aetna who says the bill is final. A few more back and forth calls and it seems like Aetna is saying this bill is finalized and they are not agreeing to the original bill. The hospital finally comes back to me in saying the claim is arbitration starting on 5/15 and it should get resolved within 90 business days but no guarantee.
I spoke with a friend who is a lawyer and deals with claims like this and he recommended suing both the hospital and my health insurance while I thought suing only the hospital made sense. I just want to get refunded the 3k I overpaid and they seem to say to keep waiting. Is there anymore I can do?
submitted by /u/two-mice-in-a-bucket
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My wife and I had a baby in August 2020 and sometime in October we got a bill that was for Nursery 2 and was billing us about 10k split between me and my health insurance (so 5k each). I called the hospital multiple times as it seemed that they were billing us incorrectly/too much as my son was not born pre-mature and that the maximum that they could charge was like $1,200 a day for Nursery 2. After a few weeks of calling non-stop and then them threatening to send the bill to claim, I finally decided to pay the bill as we didn’t want our credit to be messed up. In the middle of January, I get a notice from Aetna stating that bill has been revised, and now the total is 4k (2k to be paid by my insurance and by me). I call up the hospital who agrees and says a check will be sent in 6-8 weeks. After 8 weeks I call and they tell me it never went out and to wait another 8 weeks as the director is now signing off on it. Mid-April I call them again to ask about my refund and they state they are now disputing Aetna’s updated claim. I then call Aetna who says the bill is final. A few more back and forth calls and it seems like Aetna is saying this bill is finalized and they are not agreeing to the original bill. The hospital finally comes back to me in saying the claim is arbitration starting on 5/15 and it should get resolved within 90 business days but no guarantee. I spoke with a friend who is a lawyer and deals with claims like this and he recommended suing both the hospital and my health insurance while I thought suing only the hospital made sense. I just want to get refunded the 3k I overpaid and they seem to say to keep waiting. Is there anymore I can do?
submitted by /u/two-mice-in-a-bucket [link] [comments]Read Morer/HealthInsurance