Tuesday, September 21, 2010

can ins co pay for doctor not in their network, then not pay hosp. bill??

HMO ins. co told me I could take my child to PCP (primary care physician) that is not in their network (none in our area). Ins. co said we just pay $10.00 above co-pay.

We went to this doctor many times, ins. paid this dr. each time. We paid the $10.00 each time. This dr. referred my child to go to hospital.

Now ins. is not wanting to pay for this hospital bill cause doctor who referred this is not in their network.

I talked to ins. and they said they should have never paid these dr. bills and that is was their mistake, so I wouldn't have to pay the hospital bill and that they will.

Now the ins. co is saying they don't have record of that person telling me that.

And they said they never told me I could use out of network dr. so now they are not paying the hosp bill.

There is a person from ins.. co who is working with hospital. I called ins. co. to talk to this person. Ins. said there is no record of this person corresponding with the hosp..

HELP!