Can a hospital try to collect money directly froma patient instead of submitting a bill to an insurer?

UPDATED: Jan 17, 2011

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Can a hospital try to collect money directly froma patient instead of submitting a bill to an insurer?

I am talking about a particular hospital that failed to submit a claim to the insurance company; then started to chase me for the money (through 3rd party debt collector). How ridiculous can this get? This has happened to me at least 6 times, all by the same hospital on different occasions. Is this legal? How can I stop this stupid system? Is there anything that a lawyer can I do to stop this? Can I sue them?

Asked on January 17, 2011 under Bankruptcy Law, New York


MD, Member, California Bar / FreeAdvice Contributing Attorney

Answered 12 years ago | Contributor

Here is the bottom line. You sign documents every single time you are admitted or undergo a procedure or surgery in a hospital, which states something to the effect of ultimately you are responsible for the amounts due especially if your insurance company doesn't pay (plus or minus other language).  If you have insurance, and your insurance would have covered it, you have some major issues you need to resolve with this hospital. First, stop going back there (any judge or defense attorney in a civil lawsuit will ask the question why did you go back so many times if it happened on more than one occasion). Second, file a civil lawsuit if the statute of limitations has not run, and contact your insurance company. Third, file a complaint with the state agency who handles regulation of the hospital, including but not limited to the state medical board and of course the state attorney general.  If you had informed your insurance company about these surgeries or procedures or visits prior to going, you may have a case against your insurance company. Last but not least, pull your credit report from all three agencies, because then you will see if these monies owed are on your credit report and you will see if they lowered your score.

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