Question
What is the name of your state? Florida
I just gave birth to twins in August 2006. The hospital where I gave birth has a prepayment program for maternity. Because my insurance does not provide maternity coverage unless there is a medical complication, my husband and I elected to prepay for the delivery. I prepaid for a normal vaginal delivery ($3500). Unfortunately, I did have medical complication and had to have a c-section. The prepayment for a c-section was $6500. The day after my delivery we paid another $1500(as we were advised to do by the hospital's financial counselor) to total $5000 which is the deductible for my insurance. My insurance was then sent the claim and covered the remaining due amount.
The hospital is now trying to charge me an additional $2125.93 to cover each child's hospital stay. I spoke with a senior customer services representative at the hospital and he informed me that this additional amount is being charged because insurance is now involved. He said that if it had stayed a self pay then the $6500 would have been my total charge. My deductible for each child is $5000 so I have to pay this $2125.93 out of pocket, and my insurance will be applying it towards my deductible.
I signed an "agreement" with the hospital for my prepayment. This is everything it said:
"The Birthcare Program is based on a flat fee for all facility services, which typical includes, but is not limited to, a daily room rate, medications and lab tests. In addition, any basic anesthesia or epidurals is included in this agreement. Payment must be made prior to the delivery. Your insurance company will not be billed. If you feel that your insurance may cover all or a portion of this service, that determination must be made prior to the procedure. The hospital has no obligation to assist you in recouping any payment from your insurance company for procedures done under the Birthcare Program. Should your insurance carrier provide payment in excess of this Agreement, this Agreement shall become null and void and the third party benefit will override this Agreement."
The insurance company is NOT PROVIDING payment in excess of this agreement so I am not sure why it is now null and void. I have spent hours trying to get this all worked out with the hospital's billing and financial departments and have hit a roadblock.
What type of attorney do I need to contact to settle this case?
Thank you for any answers/assistance you can provide.
Answer
It sounds very suspicious that they are saying they wouldn't have charged separately for the well baby care (or sick baby care if they needed it) had you not had insurance. Charges assessed solely because the patient has insurance are fraudulent. But it's totally normal to have a separate charge for the newborn care; that is not usually included with the delivery, especially if the baby requires any special care.
As far as the deductible goes, does your plan have a family deductible that would apply?
Answer
Ah, it's you again, still thinking you can get free advertising for your website by pretending to be a poster. At least on this forum you had brains enough to attach it to an existing thread so you could try to get away with looking like a responder.
You pull this on the forum I moderate and your post will be deleted so fast your pants will smoke.
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That looks really funny now that the offending post has been deleted....
Answer
Well, I could delete my post, but then you'd look funny talking to yourself.