Situations that can come up when you are seeking medical assistance.
Here’s some of Joe’s recent radio segment from “Joe Knows”:
So you have an injury from an accident and you seek help when the doctor treating you says, “Oh, you need x-rays or you need to have a surgeon look at it right away.” So you follow the doctor’s advice and go to the surgeon. Then the surgeon sees you and and says, “Oh, there’s nothing wrong with you. You didn’t need to see me”. That is great to hear, however, they’re both going to file expensive bills. One might be an emergency room bill or an urgent care bill, and the other one’s going to send a specialist bill and your insurance company may not pay both. In fact, a lot of times they won’t because they’re saying they weren’t necessary.
What do you do in this situation?
First of all, you protest it with the insurance company. And if they’re all in the same group, they may be able to deal with it and process the payment. If the doctors are in your network this may also work in your favor. One might waive the bill, but if that’s not the case, you’re in a situation where you will need to reach out to the one person who you think made a mistake. In this letter you will need to state very clearly, “Listen, I’m not paying your bill. It’s not necessary. My insurance isn’t paying it and don’t sue me for this.” Let’s say they try to sue you or they don’t waive it, then you may need to get legal help and this part gets complicated. You have defenses, but these are things that you hope don’t happen, but they do happen all the time and they’re not easily resolved.
Are these situations easy to prove?
The short answer is no. Of course, they’re going to say, “Well, we did our best. We were just trying to protect you and no harm, no foul.” This happens a lot of the time. Most of these situations are very obvious that it wasn’t necessary. At that point it comes down to insurance as well and do they really have the grounds? Again, these situations become expensive and can involve levels of appeals, so it’s just painfully problematic. You will need to reach out for some legal help at that point.
If this is something you are currently faced with or happens to you in the future, we are here to help.
If you, or someone you know, wants to seek our advice or ask questions about this topic or another type of personal injury. We are available by phone, 1-800-608-3333, on the web at Stanley Law Offices or email Joe@stanleylawoffices.com.
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