Quote Originally Posted by cassiesmom View Post


This is how we used to coach patients to respond to the contractor shell game. Say to the provider: No no no no. That was emergency department care. Payable at in-network level under prudent layperson rule. I want Dr. XYZ's care to continue to be paid at the in-network level for continuity of care purposes. What do I have to do to make sure that's done? What else can you do to help me get that done?
Then call your insurance. If you contact the payor yourself they might send the claims back for reprocessing at the higher level. The squeaky wheel gets the oil, so squeak!.

I was shunted to a lawyer, and the bill sits. It's not enough for them to go to court to recover. Both the Ins. Co and the hospital have stonewalled. I refuse to pay, I actually invited them to take me to court to collect, and they have refused.

The contractor shell game is completely supported by state and federal law, so the consumer is screwed.