What to do if my former employer is self-insured for employee health benefits and I received pre-authorization approval for a procedure back but the medical providers have yet to be paid?

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What to do if my former employer is self-insured for employee health benefits and I received pre-authorization approval for a procedure back but the medical providers have yet to be paid?

I received the authorizaton when I still worked for them, 5 months ago. I am now receiving collection notices. My bills are close to $12,000. My former employer has been telling me for the past several months they are working on it but nothing has been resolved. Do I have any legal recourse I can take or can the DOL or someone help? What are my options as I do not have that kind of money to pay these bills out of pocket and don’t want my credit impacted for something that is out of my control.

Asked on December 19, 2012 under Employment Labor Law, Florida

Answers:

SJZ, Member, New York Bar / FreeAdvice Contributing Attorney

Answered 8 years ago | Contributor

First, you have to pay the medical care providers, or make sure they are paid, or else they can sue you and also report a default to the credit rating agencies; you are ultimately responsible for your own medical bills.

If your employer was supposed to pay for these bills, you can sue them to get the money they would be required to pay under the terms of your health care benefits. The department of labor will not help you with this--you most likely need to bring a lawsuit yourself.

However, lawsuits take time--that's why you should find someway to pay the bill so that you do not, in the meantime, suffer the consequences of a default. You should see if you can't work out a payment plan that you can afford; then, as you are paying, if your employer does not honor its obligation, you could file a lawsuit.


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