So my wife and I were having a baby and had to go to a specialist during the pregnancy. When we set up the appointments with the specialist my wife was covered by two insurance companies, one through my work and then another through her Native American Tribe (The tribe covers everything that Primary Insurance doesn’t). When we set up with the specialist we put down both of her Insurances and everything was fine.

Flash Forward a few months later, we get a bill from the Hospital from each of the visits that we did there. I called the hospital and they told me that our Primary Insurance ended up not picking up the bill because my wife was still covered by her parents insurance company (we were not aware she was still listed there) and technically her Parents Insurance is meant to be the Primary. I ended up calling her Parents Insurance company and they told me that all they need is for the Hospital to forward the original claim to them and they may/may not pick it up depending on the timing/other factors. I also called my work insurance and they told me that if her parents insurance doesn’t pick it up, that we can get a letter of decline and they would probably pick it up again. SO at this point I had both insurance companies telling me to tell the hospital to forward the claim and it will be taken care of.

I call the Hospital and tell the lady that all we need is to forward the original claim to my wife’s parents insurance. She tells me that she doesn’t think that would work because at this point it was like 7-8 months after the original claim time and that they probably wouldn’t accept the claim. I told her that I was aware of the timing but that the insurance company said that if we forwarded them the original claim that it wouldn’t be an issue. She said she still didn’t think it was work but would go ahead and try.

See also  Who gets a better deal: Health plans or self-insured employers?

A few weeks later we get another bill. I call the parents insurance thinking that it got denied, and asked for the info on the claim. The wonderful lady working for that insurance company informed me that the hospital never resubmitted a claim to them. So I called the hospital again and asked why and they told me they wouldn’t do it because it was too late… I tried to argue with them but they weren’t budging.

So here is my question, that bill has now been sent to a debt collector. Is there any legal action I can take against the Hospital since they outright refused to forward that claim? I literally had both Insurance Companies telling me that’s what they needed but the Hospital refused.