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[US-CA] Hospital Billed for 50k , Ins Declined. Sent to Collections without notice

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  • [US-CA] Hospital Billed for 50k , Ins Declined. Sent to Collections without notice

    First , Thank you for all your help. I need some help. My father came from overseas to visit us for a few weeks. A month and half into the visit he had to be admitted to ER (1 day) for a TIA. He was on Blood Pressure medications but he never had a TIA before. He went back to his country to origin after about 2 weeks. Few days later we received a letter , in name of my father, from the Visitor insurance co. notifying him that the bill raised by the hospital for about $50k for the ER Visit has been declined due to pre-existing condition. We appealed this decision twice over last 12-18 months but was shot down due to pre-existing condition.

    Now , before we could reach out to the hospital to talk about the bill. He got a notice from a collection agency based in US-CA in his country of origin. We called the hospital but realized that the bill had been sent to collections without sending us a statement. When we tried to clarify the hospital said that this is the process where they do not send bill overseas and neither to the local address provided since the patient ( my father ) is from overseas. Essentially , we never got a chance to make a payment before the bill was sent to collections.

    What can he/we do next ? Has anybody been in this position before ? We have yet to contact the collections agency and have yet to respond to the first notice sent by the collection agency.

  • #2
    In order for TIA to be considered pre-existing condition, it is not necessary that the person had a history of TIA.

    If the medical records submitted to the insurance company indicate that it was due to blood pressure, it would be considered as pre-existing condition. And if the person is above the age of 70 years, pre-existing conditions would be excluded.

    I suggest that you negotiate the bill with the hospital and/or collection agency, ask for a big discount, and pay it off in lump sum or in installments.
    Thanks & Regards
    Insubuy
    Toll Free: (866) INSUBUY
    Local: (972) 985-4400
    Fax: (972) 767-4470
    Website: http://www.insubuy.com

    Comment


    • #3
      Originally posted by insubuy View Post
      In order for TIA to be considered pre-existing condition, it is not necessary that the person had a history of TIA.

      If the medical records submitted to the insurance company indicate that it was due to blood pressure, it would be considered as pre-existing condition. And if the person is above the age of 70 years, pre-existing conditions would be excluded.

      I suggest that you negotiate the bill with the hospital and/or collection agency, ask for a big discount, and pay it off in lump sum or in installments.

      Thank you , the only issue that we have here is that we were not given ANY bill from by the hospital and it was directly sent to the collections agency. We did not even get a chance to talk to the hospital because our 2nd Appeal with IMG got settled couple of days ago. This is really frustrating.

      Do you have an idea how much % discount we can negotiate for ?

      Comment


      • #4
        If hospital didn't give you the bill, you should complain it back to the hospital about why they didn't do that.

        It is hard to say how much discount they will give. May be 20-40%? It depends upon whether you will pay in lump sum or in installments.
        Thanks & Regards
        Insubuy
        Toll Free: (866) INSUBUY
        Local: (972) 985-4400
        Fax: (972) 767-4470
        Website: http://www.insubuy.com

        Comment


        • #5
          Similar situation

          My father is in similar situation. Can you share how you managed to settle this or is still ongoing?
          Any updates would be helpful.

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