Beyond everything else we've experienced, we now have the insurance company refusing over $300k in claims dating back to August. There was some confusion over our insurance cards when Nathan was first admitted to UMMC, and it wasn't until October that we were informed the wrong cards had been submitted. The claims have since been batted back and forth between UMMC and MAMSI, and now both sides are refusing blame and dumping the bills on us.
MAMSI has never denied that our son was covered for these procedures. They are refusing the claims solely on the basis that the hospital hadn't submitted the claims to them in a timely manner. The hospital is claiming that we never gave them the correct insurance information (we did after we were informed they had the incorrect cards... months later). We need some professional representation, this justifiably scares the hell out of us. We could lose everything we've worked so hard for over the years. It doesn't seem fair, given everything else we've had to endure.
Can anyone recommend a lawyer specializing in this field? We are in the metro Baltimore area, although any good firms in the MD/DC/VA area would be welcome. If you have my email, please send me a private message. Otherwise, a comment below would be fine.
Thanks,
Jason
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7 comments:
Jason,
My limited understanding, is that timely fashion means from the date of a denial, not necessarily the date of service. In my experience, it helps to keep calling back - everyday - until you get a representative who actually helps you. Each rep from the insurance company will give you another answer. I will try to keep investigating for you.
Becky Grove
Jason,
The Doctor I work for gave me the name of a lawyer in DC. His name is Steven Nemeroff. He said he is pretty expensive. I talked to the billing girl on our office. She did some research and said that you should contact the state insurance commission. They should be able to help - for free. I wish I knew someone in billing at UMMS. Unfortunately I don't. Our home phone number has changed. I will send an email to Christa. Please call if there is anything we can do. Becky Grove
Jason - I don't know of any lawyers, but my aunt used to do work helping seniors deal with problems between the hospitals and insurance companies. I emailed her to see if she has any suggestions aside from finding a lawyer. I'll let you know if she has any ideas.
Meryl
Dear Jason & Christa,
I only know of one great attorney, but he's in Tallahassee (my Jason) and his firm most likely doesn't do this kind of law. But he's a pit bull and would love to take on both the hospital and the insurance company! I did ask my Sunday prayer group to put you back on their lists, and one woman said " Well of course we will, they can't do this to our Nathan's parents" Made me chuckle, cause we do on some level feel ownership of your wonderful son! Keep us posted and let me know if there is anything else any of us can do.
Love,
Aunt Barb
Dear Jason and Christa,
Have spoken to my pit bull attorney son, and he's going to contact someone from his Tampa firm that has dealt with hospital/insurance cases. Hopefully that will give us some further insight in how to handle this MESS! Can't believe the hits still keep coming!
Was at the ladies group last night and when I asked them to put you back on their prayer list, one woman said "of course we will, they can't do this to OUR NATHAN'S parents" Guess we all feel some level of ownership to your wonderful son! Let us know if there is anything else we can do for you!
Love,
Aunt Barb
Jason and Christa,
Everyone at the hospital has read this and we are so sorry. I am keeping you both in my prayers. give Nate a big hug for me!
Nurse Kara
there is always that option of going to the media about things like this, the concerned parties (hospital and insurance company) usually does an excellent job once things get in the news.
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