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Unread 11-23-2010, 01:06 PM   #1
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Default Got a hospital bill although we have Tricare

We're not supposed to pay anything for mental health care. I got a hospital bill for over 3000$. They say my insurance doesn't cover this and I'm responsible for it. We called the insurance company (Tricare), and it turns out the hosptial never billed them for the full amount. Called the hosptial again, they don't see their mistake, still say we're responsible for the 3000+$.
I just got outo fthe hospital, and this is really stressing meout. I don't know what to do about this. The hospital refuses to call Tricare. This is very upsetting.
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Unread 11-23-2010, 03:04 PM   #2
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Default Re: Got a hospital bill although we have Tricare

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Originally Posted by whenwillitend View Post
We're not supposed to pay anything for mental health care. I got a hospital bill for over 3000$. They say my insurance doesn't cover this and I'm responsible for it. We called the insurance company (Tricare), and it turns out the hosptial never billed them for the full amount. Called the hosptial again, they don't see their mistake, still say we're responsible for the 3000+$.
I just got outo fthe hospital, and this is really stressing meout. I don't know what to do about this. The hospital refuses to call Tricare. This is very upsetting.
Can Tricare take the bill from you and then pay the claim? It sounds fishy, like the hospital doesn't want to accept Tricare as payment (even though they should) so they try to bully you into paying.
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Unread 11-23-2010, 05:52 PM   #3
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Default Re: Got a hospital bill although we have Tricare

I had that happen to me where a hospital turned a bill over to a collection agency and it kept bouncing everywhere but to my insurance! Luckily I worked for a large nonprofit association and it had a legal department and the head was an old boss of mine and told me what to say in a letter to the legal department of the hospital!

I suggest you do that, write a letter to "Legal Department" Umtiumph Hospital and give them all the facts in your case and they'll take care of it. They don't want a law suit when they're clearly to blame.
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Unread 11-24-2010, 10:38 AM   #4
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Default Re: Got a hospital bill although we have Tricare

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Originally Posted by Amazonmom View Post
Can Tricare take the bill from you and then pay the claim? It sounds fishy, like the hospital doesn't want to accept Tricare as payment (even though they should) so they try to bully you into paying.

They won't do that. The hospital has to bill them.
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Unread 11-24-2010, 10:39 AM   #5
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Default Re: Got a hospital bill although we have Tricare

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Originally Posted by Perna View Post
I had that happen to me where a hospital turned a bill over to a collection agency and it kept bouncing everywhere but to my insurance! Luckily I worked for a large nonprofit association and it had a legal department and the head was an old boss of mine and told me what to say in a letter to the legal department of the hospital!

I suggest you do that, write a letter to "Legal Department" Umtiumph Hospital and give them all the facts in your case and they'll take care of it. They don't want a law suit when they're clearly to blame.

That's a good idea,t hank you.
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Unread 11-24-2010, 12:42 PM   #6
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Default Re: Got a hospital bill although we have Tricare

Yes, it's nice because you can be nice since you're clearly right, you can express your frustration and ask for their help instead of yelling at one of the two parties that is treating you like a ping pong ball.

Warning, I didn't get any answer from the legal department, suddenly the problem just went away, like magic They don't want any bad press either and I'm sure they don't want people to suddenly realize there's a legal department and bombard them (hence, no response from them). It would have never occurred to me to think of it if my old boss hadn't mentioned it but it does make sense.
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Unread 11-24-2010, 06:19 PM   #7
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Default Re: Got a hospital bill although we have Tricare

if you're military take this up with JAG.
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Unread 11-25-2010, 07:04 AM   #8
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Default Re: Got a hospital bill although we have Tricare

I agree with perna, totally. It is not up to the hospital to decide who will or will not pay it. That is up to the insurance company and writing a polite but firm letter to them stating in a centred font "To whom it may concern" and then on the next line "Without Prejudice".

Then state your case and you can be assured that they will believe that you have already received legal instruction to ascertain your position. It will help your case even more if you have a letter from the insurance company stating that they have not been billed and so cannot assess the claim.

Best of luck with it, and though it's easy for me to say, please try not to stress as you work your way through this.

.
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Unread 11-25-2010, 10:51 AM   #9
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Default Re: Got a hospital bill although we have Tricare

Please speak with Tricare before believing the hospital.
Sometimes a hospital's billing and the insurance payment cross in the mail, so it could be that they have not yet received full payment, or they may not have submitted all the charges yet (even if the customer service rep thinks they did). Hospitals bill according to their billing cycle and sometimes late charges are posted after the initial billing, because they are discovered 'late', after the initial billing.

Another option, to make sure you are getting the correct information and that you understand the reasons, etc. is to contact the patient accounts supervisor for a full explanation.

Another option is to copy the bill you received and send it to Tricare with a note about your phone call, the date you called, who you spoke to, and what they told you. Ask Tricare to follow up on it.

A last option, and it works well, is to file a complaint with your state's insurance comissioner. Those complaints affect the insurance company's rating, must be handled quickly, and must the resolution must be approved by the insurance comissioner. Keep a copy of this complaint for yourself.

I hope this helps.
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Unread 11-26-2010, 01:55 PM   #10
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Default Re: Got a hospital bill although we have Tricare

Sometimes hospitals have ombudsmen, who help patients with issues like this.

Very frustrating. Good luck to you.
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