I had to have a second back surgery due to an infection I got while in the hospital during 1st back surgery. I do not think I should have to pay my part of the bill as the (hospital) is at fault. I don't think my insurance should have paid their part either! I spoke to my insurance company as they paid the bill and they said they called hospital and they stated they coded it correctly! Well DUH of course they did - but that was not the issue! They(insurance co) said I would need to write a letter disputing the claim and why. Any advice?
State/Country relating to question: Kentucky
Googled how to write a dispute letter
Hi - my name is XXXXX XXXXX X'm a Personal Injury litigation attorney here to assist you.
Obviously, the claim is that you would not have incurred the charges for the second surgery, hospital stay, medication, etc. had the medical providers not been negligent with the first surgery.
What you have to look at is whether or not it is common for this type of infection to ensue after a surgery like yours, or is it something that should not happen or that rarely happens, but is caused by some failure of the medical staff.
If you can prove that the infection was caused by the negligence of the medical provider, you can dispute the bill on that ground. In fact, you would have the right to sue the medical provider for the injuries you sustained, future medical treatment, lost work, etc. if you can prove that their actions were negligent.
In order to do this, you will have to get a medical professional to review your medical records, and if the medical professional (doctor, usually) finds that the providers fell below the applicable standard of care at any point, you would have a right to sue.
The best way to get the ball rolling is to see a personal injury attorney in your area and have him/her get in touch with the appropriate medical professional to review your bills. If fault is found, you can discuss proceeding to file suit.
You certainly can write a letter stating that you dispute the charges and your liability for the debt based on the fact that the hospital's negligence is the reason you incurred the expense, and that you should not have to pay for mistakes they made. However, it is likely going to fall on deaf ears until you hire an attorney to go after them.
OK - I have an attorney looking at my case and they will be deciding if I have a case after looking at my medical records. Since I have to do thre letter within 6 months of the date of dispute-around the time of surgery-Feb 2012 - I should just wait till the attorney takes the case? Should they be able to help with the letter?
Yes, the attorney can draft and send in the letter for you. There's no harm in giving it some time before mailing in the letter, but just make sure you don't run out of time.
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