SCREWED- Student insurance victim

[luxury_inc]

What is the name of your state? California

In 2003, I was in a terrible car accident and as a result had a lot of medical bills. I met the maximum out-of-pocket costs very quickly. The surgeon who operated on my broken finger in February of 2003 was paid in full. Six months later, a second operation on my hand was needed in order to have full use of my index finger. Prior to the second operation, I went to Student Health Services and talked to the insurance represenatative and follwed all of her requirements, which included getting a Student Health doctor's referral and carrying a copy of the referral form from Student Health Services to the office of the same surgeon. I was assured that I would incur no expense to have this second operation (ie: my insurance company would cover the costs 100%).

I spent 2004 studying abroad and came back to a letter from a collection's agency on this unpaid bill. They are pressuring me to "make a deal" so that my credit rating does not get ruined. Also, the interest is at 10%, roughly $300 a year.

When I filed an appeal, my insurance company said the surgeon's charges exceeded reasonable and customary, and I would have to make up the difference (they did pay a portion of the bill.) They also said that the representative at Student Health on campus is not a representative of their company.

QUESTION: I was told (by a Student Health representative and my surgeon) that my insurance company would pay 100%, not simply 100% of what they feel is reasonable and customary, what can I do, the bill is $3,000 and growing?

Poor, screwed student

 

[somarco]

Neither student health, nor your provider(s) are in a position to make binding commitments for your carrier. It is your responsibility to know what is covered, what isnt. The fact that one (or more) providers charge in xs of R&C is as much their problem (for charging too much) as it is yours.

Bottom line. You received the services, you signed the financial responsibility forms, you are responsible for what your carrier did not pay.

You can try to negotiate with the providers to accept a lesser amount, but the fact this has (apparently) gone on long enough to be turned over to collections weakens your negotiating strength. If this has gone to collections then it is (most likely) already in your credit report. By settling sooner rather than later maybe you can escape with minimal damage.

 

[purple2]

If this happened in an auto, why isn't it covered by auto insurance vs. medical?

 

[somarco]

Good question, Purple.

OP did not indicate if another driver was involved so I assumed it was a single car accident and Screwed was the driver. Med pay would kick in if he had that coverage. Even then med pay is usually limited to $5k or less.

Based on other info that limit would have passed some time ago.

 

[luxury_inc]

Poor screwed student

You're right Somarco, it was a single car rollover, without auto med pay coverage, I was the driver.
Now, according to the insurance co., the doctor is no longer their PPO provider, sometime between the first and second operation he dropped out. No one told me this as we sat in his offices scheduling the operation to coincide with the time period before my next year's deductable would start again!
My book smarts are pretty good but my life experience is just beginning. Please forum, in view of the facts given, I need some pointers on negotiating: forgiving the balance, a lesser amount, small payments, no interest?? what and how do I ask for. The collector said that this is not in my credit report yet.
Thank you all,
S... Student

 

[somarco]

When the doc resigned from the network you lost your bargaining chip. As long as he is party to the PPO contract he is required to bill you the contract rates, no more. Once he leaves the network all bets are off and he can charge what he wants.

Debt negotiation can be tricky. You said the total was $3k. How much can you come up with right now? A cash payment of 75 cents on the dollar might make it go away. If you have to drag this out in monthly installments you lose leverage.

Do what you must to get your hands on cash, now. Relatives, friends, whatever is legal & moral. Take a couple of jobs and work it off. See if you can get a bank to loan you money. If credit is an issue consider a subprime lender.

Good luck.