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TJ, Esq.
TJ, Esq., Attorney
Category: Legal
Satisfied Customers: 11784
Experience:  JD, MBA
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While visiting my family in the state TN, Memphis I had a pain

Customer Question

While visiting my family in the state TN, Memphis I had a pain and walked in to the Emergency room there.
I gave them my NY State ID and (NY Medicaid- Fidelis Care Insurance Card)
The ER registered me as uninsured and sent my bills to collection agency after 2months, the collection agency is going to make a credit report after 3weeks.
I contacted constantly Fidelis Care insurance and the hospital to resolve this issue. The problem is, the hospital representative says they tried to bill my insurance but the insurance is invalid/denied, the Fidelis Care insurance representative says they've never received any claim from that hospital and I am not responsible for the hospital bills as a medicaid patient.
I mailed, faxed my ER bills to Fidelis Care insurance but they are saying they have not received any bills.
Please assist, I am tired of trying to resolve this issue, I don't have any idea why this all happening and the representatives of both sides useless on the phone by mail. The hospital just wants their money through the collection agency now when I was the NYS medicaid patient when visited the ER.
Submitted: 1 year ago.
Category: Legal
Expert:  TJ, Esq. replied 1 year ago.
Hello and thank you for the opportunity to assist you. My name is ***** ***** I will do my very best to answer your legal questions. While I can't say for certain what the problem is, based on what you wrote it sounds like the insurance company is the problem. First, why wouldn't the hospital send the insurance company the bills? Clearly, the hospital would rather be paid by your insurance company, than not be paid and send your bills to a collection agency. Second, you wrote that you faxed the bills yourself to your insurance company, and that your insurance company claims not to have received them. For me, that is a red flag. If I were in your shoes, I would tell the insurance company that if the bills are not paid immediately, then you will not only sue for the cost of the bills that it should have paid, but also for any damage that you suffer as a result of your credit being ruined due to the bills being sent to a collection agency. I would communicate entirely by written letter (which you can also fax, though I would certainly mail the original), and the first part of the letter would explain the situation (as you explained it to me). The second part can make the threat that I posted above. I suspect that the bills will be promptly paid at that point. But if they are not, and you have to sue, then you will at least have that correspondence to show that you took measures to inform the insurance company of what was happening. Does that answer your question? Please let me know if you need clarification, as I am happy to continue helping you until you are satisfied.

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