I recieved a medical bill in September less than $5000 on medical service performed on me on July 2011.
3) Before the procedure, I confirmed with my insurance company for preauthorization. Before I checked in the hospital, which is billing me wrong balance, I made sure the hospital has preauthorization for my procedure. When I received the bill for the first time, I contacted my insurance and was told that the hospital submited and was paid under "incorrect code." The hospital billing department, so I told by my insurance company, simply need to resubmit with the right code. However, the hospital insisted that they are charging me correctly. I requested numerous time to speak to a manager but never received a phone call back. Physician's office sent the correct form to the hospital a couple of time to show that my procedure is "inpatient" instead of "outpatient." By hospital billing department putting my procedure under "outpatient" my insruance only covers my procedure as "unauthorized procedure."
Ever since the first bill I received, my objective was simple; to have the hospital to file correct claim to my insurance company with the right code.
In October, I had my physician's office to send the preauthorization forms and correct forms to hospital; there were three fax transactions. The hospital shows no record of receiving this document. On November, my physician even wrote a letter stating that the procedure should be under "inpatient."
Now the hospital is saying that I pass the deadline of "within three months" to change the status; the information that was never disclosed to me prior to May of this year.
Yes, I do have the copy and the fax transaction of multiple tries to send the physician's letter via fax.
During this process to have the hospital to correct the code, I received phone calls and statement of bills although the account was supposedly under review. I was told by the hospital billing department that I need to call what they call " bill collecting agency" separately. I have done so fatefully. But I discovered two weeks ago that the hospital and the billing collection company use the same data base.
During this time, I was given several ultimatums and was urged "you pay or else."
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What information I'd need to represent myself in the small claims court?
Specific answer would be appriciated.
Because I was already aware of the inital answer you gave me :-D
Would I need to request a copy of internal fax transition record from my physician's office of their effort to send the correct form in October?
How can I prove without any voice recording of the phone conversation?
I see the high possibility of "he said, she said" because the hospital conveniently erased the record of me contacting them in September; the hospital billing department has a customer service record dating back only to November.
If this affects my case of proving that I'm speaking the truth, how do I go by requesting phone call communication from my cell phone provider? Would this have any effect on strengthening my case on dispute?
I kept all the records of phone call conversation and representatives names.
So it does not matter that the hospital does not recognise the representatives names?
How do I go about requesting my physician to be my witness?
She may not agree to be involved since she needs to use the hospital for her other patients.
Are you familiar with procedures relating to small claims court?
I found several websites explaining the situation but I feel I need some guidence on overall picture of filing a suit in small claims court. Please help.
i.e. how do I include the court fee or suit filing fee into dispute?
Is the defendant going to be addressed as hospital or the billing department?
How do I increase my chance of having the court approving third party subpoena?
Although I'm confident that my record keeping is strong enough, how do I prove the conversation record is true and information I needed from the very beginning was not disclosed?
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