Legal Question in Credit and Debt Law in Maryland
medical fees and insurance
My spouse was recently hospitalized. Although the primary physician and hospital were PPO, I discovered later that most of the testing/diagnostic services within the hospital were not PPO. My insurance company and the billing agents inform me that I am liable both for the 30% of the insurance's allowed amount (in accordance with the service being non-PPO) and the full amount that my insurance company has determined to be not allowed. Are they correct?
1 Answer from Attorneys
Re: medical fees and insurance
The contractual language that you reference appears to be based on co-insurance requirements. Typically a PPO does not operate under co-insurance but rather under an HMO structure that provides for co-payments. Without seeing the actual contact language no determination can be made as to this issue.
It is my experience that often debts can be negotiated. You may attempt this without an attorney; however, upon engaging an attorney and having previously attempted to resolve the debt you may have already compromised any ability to reduce the claim.
My practice routinely involves dealing with medical billing and other medical related matters. Should you require assistance I may be contacted at (410) 799-9002 or by return e-mail.
Related Questions & Answers
Looking for something else?
10,200 active attorneys ready to answer your legal questions today.
Featured Attorneys
Earn additional revenue and grow your business.
