ER visit, insurance company denied my claim, HELP!!?

In novemeber of last year i went to the ER to recieve stiches on the knuckle of my index finger. I ended up recieving 3 stitches. i gave the treatment center (Mercey Hospital in Iowa City) all my information at the time of the incident. Some time passed and apparently the hospital forwarded the entire case to some creditor who started calling me like crazy. The first time we spoke i told the creditor i'd have my father fax him our insurance card. My father eventually did it (something like 2 weeks later). When my dad told me he handled it i called the creditor whose secretary informed me that all the information had been recieved. Several months passed (it was now March) when he began calling me again telling me he couldnt read the insurance card my father faxed him. Let me repeat that, this was several months later. I didnt pay much attention at the time and he eventually stopped calling. Several more months passed and it was now June when he began calling me again saying that he miraculously figured out how to read the card, and forwarded it to Mercy, who then in turn billed my insurance company, who then denied the claim due to the time it took to file. What am i suppose to do??? the reason it took so long was becasue of the f**kin creditor. Now hes harrassing me again telling me i owe $750.00 for three stitches!!! i am a poor college student whose family is already struggling to send him to the university of iowa (i live in chicago). Is there anything i can do to make the insurance company take the claim??

Update:

Dear "Jo",

i didnt go to the university of iowa hospital student health facility because it was closed. and btw ur long winded answer accomplished absolutely nothing. but i do appreciate the time u wasted attempting to reprimand me. Im sure when you were a freshmen in college you carried your father's insurance card with you everywhere you went.

8 Answers

Relevance
  • Jo
    Lv 4
    1 decade ago
    Favorite Answer

    If you are covered by your father's medical insurance, you should have your own copy of the card. You should have been able to give it to Mercy when you went in for the stitches. Since you evidently didn't have your own copy, your father should have sent a copy of his card to Mercy as soon as he could. There should have never been a credit agency involved in this in the first place. You should have called Mercy as soon as you got your first bill from them. If they did not have your insurance information, they could have told you what they needed from you and where you should send the information. An insurer can deny a payment if they receive the bill too late. Your father should have that information in his handbook about his insurance policy.

    Question: If you are a student at the University of Iowa in Iowa City, Iowa, then why did you go to Mercy Hospital? You should have used the University facilities. I believe that each of the state universities in the State of Iowa (and many of the private colleges and universities in the State of Iowa) has a student health plan to deal with emergencies. Since you are a student at the University of Iowa, it would have been logical for you to have gone to University Hospital at the University of Iowa. It is a pretty big place on campus.

    ****Just

    My dad was killed 6 weeks before I graduated from HS. My mom had to raise my younger siblings on social security. I didn't have any medical coverage at all while in college (no medicaid or anything back then). My only choice was what I could get at student services at college (and we didn't have our own hospital on campus, just a part-time campus nurse.) Somehow I don't feel all that sorry for you. As you didn't notice, I asked why didn't you go to the University Hospital. Student services closes, the University Hospital doesn't close. And, yes, the insurer can refuse to pay a claim if they receive the bill too late. They aren't responsible if you don't follow the guidelines about submitting the claim. You can try to deal with them, but they don't have to pay if you didn't make sure they received the bill on time. The hospital billing your insurance is a service to you. If you didn't get them your insurance, they can't bill your insurance. They will bill you. You have to submit it if they don't have the information to do it. I never had health insurance until I got married since my dad never had it thru' his employer. Lots of people didn't have it back then and no gov't plans back then either.

  • Anonymous
    1 decade ago

    You gave the reason why they denied your claim - >>>>>>>>>>it wasn't submitted in a timely manner. <<<<<<<<< They can deny your claim for such a reason. There are time limits stated in the policy. You are lucky to have a father who has insurance from his employer while you are in college. If you read the other answers, you will see that Kimberle didn't have insurance through a parent while in college. You will also see that Jo's father died while Jo was still in HS and didn't have any insurance while in college. Stop being a crybaby about this. It is a learning experience for you. Next time, carry your insurance card in your billfold (they fit in there nicely) and present it when you need care. If you are in such an emergency and you don't have it with you, get it to the hospital as soon as you can. Don't wait around for months waiting for others to do what they can't do since you didn't do what you should have done. Only whiny crybabies get mad at people about how they must have carried their father's insurance card around with them while they were in college when>>>>>> they didn't even have a father to have insurance! <<<<<<<<What a crybaby you are. And how did you miss University Hospital on campus? I guess there are a lot of us here that have been to U of I and have seen the hospital. It is a big place. It is even bigger than Kinnick Stadium.

  • 1 decade ago

    Just wonderinnnn

    You didn't like Jo's answer. You said that the student health center was closed. Jo also mentioned the University Hosptal on the campus of the University of Iowa. You should have gone there if you were a student instead of going to Mercy (University Hospital doesn't close). I guess you didn't notice the hospital on campus. It is really big. Some of us weren't lucky enough to have insurance from our dad's employer when we went to college. We had to make do without. And you use nasty language.

  • lucy
    Lv 7
    1 decade ago

    1st off call the insurance company of your father and ask them why they are denying.

    my guess is that your fathers deductible maybe over $1k so since this bill is $750 would be less than your fathers deductible and would not pay which would suck.

    if the deductible is more than your bill, your next option maybe to call the hospital and explain your circumstances and ask if they will give you a discount if the insurance does not pay.

    granted you went where you had to due to the circumstances of the time. if the insurance company states that this hospital is out of network and does not cover, then you have an argument that the health facility was closed and since you had stitches, what were you to do, wait 12 hours and hope you don't need stitches?

    insurance companies are notorious of sending letters asking why you got treatment to delay. my husband has a $2,500 deductible, pays the doctor in advance since he knows they wont pay, but they continue to send letters asking him the reason of the doctor visit which they will never pay since under his deductible.

    see if they are willing to accept less, since when they send to collections, they sell the debt for pennies on the dollar.

    good luck

  • How do you think about the answers? You can sign in to vote the answer.
  • CatDad
    Lv 7
    1 decade ago

    What was the insurance company's reason for a denial? It's my understanding that a accident like yours that was treated within 24 hours of the time of the injury cannot be denied....unless there is some sort of deductible that applies to ER care. You should re-submit the claim to the insurance company with this info: the date of the accident (hopefully this was the same day that you were treated in the ER)

  • debijs
    Lv 7
    1 decade ago

    ~~Send a letter by certified mail explaining this to your insurance company. They may then accept the claim, since the denial was due to paperwork errors. Make sure you get a return receipt, and if they still wont pay, then take them to small claims court. Also, make sure you send a copy to the creditor who is harassing you, same way- certified mail and return receipt requested. They can't pursue the collections while you are actively seeking a remedy of the claim.~~

  • 1 decade ago

    Sue the collection agency, sue the hospital

  • Anonymous
    1 decade ago

    So, why is your question "... insurance company denied my claim..." when it is the "creditor" who messed you over?

Still have questions? Get your answers by asking now.