is ready to sue us for collection of a hospital bill of over $7,500. (This is from a collections law firm.)
The thing is, having reached our deductible before the hospital submitted their bill, my insurance company paid 100% of their charges (over $68,000 at this point) with the exception of the $7,500+.
When the hospital started dunning us with bills, I called the insurance company to ask why it wasn't paid. They turned the matter over to a company that verifies medical bills.
The rep assigned to this case wrote me that the charges were "lacking <in> sufficicent documentation, and billed inappropriately."
The rep told me that even after we wrote a letter to the hospital authorizing them to deal with the rep, they have refused.
The hospital in question has not responded to any letter we have sent them or to numerous requests that they provide the insurance company with more documentation.
This morning, the legal department of this collections law firm told me that the hospital refused to send anything more or any more documentation to the insurance company than was originally supplied and that they would not deal with anyone authorized by us to try to fix this matter.
The man said he would try to get a reduced amount settlement for us from the hospital, but that it was not for the insurance company to pay; any settlement would be for us to pay.
The law firm rep has said that he will request that the hospital send me an itemized copy of the hospital bill, but that would be up to the hospital to decide. (We have never received an itemized copy of the bill.)
In the meantime, I have been trying very hard and cooperating with the collections law firm to try to get this resolved, only to find out this morning that they did not contact the hospital (who by the way has recieved copies of all correspondence on this matter.)
Four years ago, we had a similar bill from the same hospital which the insurance company refused to pay. I requested and got an itemized copy of the bill at that time. It was all pharmaceuticals. I took it to a pharmacist friend, told him that the hospital was offering me a settlement on the account for $1,000.
I asked him whether or not I should try to get the insurance company to pay or take the settlement.
He laughed and told me, "Take the settlement, Jo. There is no way your insurance company is going to pay this. You see this drug? I can get you two thousand of them for what they charged you for one."
So I took the settlement, complaining that they had grossly overcharged us. The answer from the hospital Accounts Receivable rep: "We can charge you anything we want."
This time I asked my insurance company to settle this with the above result.
My question: Am I being scammed by the hospital and the collections law firm? Do I need to get a lawyer, which will cost big bucks? If they offer the same thousand dollar settlement, (which I can't afford without selling most of the share in the college fund I started years ago for my son), should I take it?
I also have about $5 or 6,000 in other legitimate medical bills that need paying.
Help.