Hospital double billed and refuses to send refund

calamtykel

Hospital double billed and refuses to send refund

calamtykel

I'm hoping someone can help me when I call the hospital billing department today.

 First, in December of 2010, I had a series of rib x-rays ordered by my oncologlist.  We had just started a new year of insurance Dec 1 with Aetna, a new carrier for us.  They denied $318 of the bill.  Our church paid it for us in April and I have the canceled check information for that.

Then in May I guess it was resubmitted and Aetna covered the $318, paying the hospital directly.

 I found out about this on January 4 of this year when I was talking to the billing dept about another bill.  She said 'YOu have a $318 credit with us" and agreed, at my request to send me a check for that amount.  I had originally asked it be applied to a bill already in collections but they refused - stating that since the bill was "sold" that they could not apply it.

Well, no check came.  So yesterday I called.  The first person I talked to denied any knowlege of the $318 so I hung up and got together:  The bill, the canceled check info and the EOB from Aetna stating that they paid it.

This time I got hold of someone who after one million "hold on's" and putting me on hold, acknowleged that it had indeed been double billed and double PAID.  However, on Janaury 18 of this year, they "applied it to a different account".  I asked WHAT account, since my accounts with this hospital have been cleared, even the ones in collections!

She has no information and told me to call back; but that since I still had a "balance" with them (I guess the collections agencies have not cleared our accounts with them yet" that I was NOT ELIGIBLE FOR A REFUND.  Even though they collected twice on this bill!  (So they're using it as blackmail?) 

I asked which account it was applied to - no information.  In the same conversation she also told me that it was "reversed" (not sure where) and "Paid to aetna".  Now, WHY would you pay my insurance company the amount when they covered it??

So I've been given 100 different stories and no information.  I was told to call back after 12:00 yesterday and talk to someone else but I wasn't home, so now I have to call back today.

I think they are really just playing a game and I need to play hard ball.  Can anyone give me any info to threaten them with?  Reporting them to the state insurance commission?  Is there a state agency that oversees hospital billing frauds?  I can't seem to find anything.  I want this money either refunded to me or to my church who paid it --but seem to be getting nowhere!

MadisoninMd

Mentioning your state insurance commissioner is aware will help. I would also mention that you have all documentation ready to send to them but wanted to give the hospital one last chance to work it out. Try going to hospital CEO directly instead if billing people. Aetna themselves may be of assistance if you mention the word fraud. You can also ask Aetna to withhold the money from another claim for you or another patient.



Best of luck getting it straightened out!

gramamuses

So frustrating to say the least!!  Have you considered checking with social services dept. at the hospital?  They can wade through the red tape (if they will ).  Haven't run into your situation but others matters have been worked through via soc. services for us.  Good luck, and keep at it until you get the refund.

apple

I;'ve had great luck with Aetna.. and sending a copy to the state insurance comissioner will help.

good luck indeed.. it is so hard to navigate  thru coorporations.

sweetbean

Call your State Attorney General's office.  You can fill out a complaint and they will investigate.  Getting the government involved really gets their attention.  Plus, that is what the SAG's office is there for.