Got a hospital bill although we have Tricare

We're not supposed to pay anything for mental health care. I got a hospital bill for over 3000$. They say my insurance doesn't cover this and I'm responsible for it. We called the insurance company (Tricare), and it turns out the hosptial never billed them for the full amount. Called the hosptial again, they don't see their mistake, still say we're responsible for the 3000+$.
I just got outo fthe hospital, and this is really stressing meout. I don't know what to do about this. The hospital refuses to call Tricare. This is very upsetting.

Can Tricare take the bill from you and then pay the claim? It sounds fishy, like the hospital doesn't want to accept Tricare as payment (even though they should) so they try to bully you into paying.

I had that happen to me where a hospital turned a bill over to a collection agency and it kept bouncing everywhere but to my insurance! Luckily I worked for a large nonprofit association and it had a legal department and the head was an old boss of mine and told me what to say in a letter to the legal department of the hospital!

I suggest you do that, write a letter to "Legal Department" Umtiumph Hospital and give them all the facts in your case and they'll take care of it. They don't want a law suit when they're clearly to blame.

They won't do that. The hospital has to bill them.

That's a good idea,t hank you.

Yes, it's nice because you can be nice since you're clearly right, you can express your frustration and ask for their help instead of yelling at one of the two parties that is treating you like a ping pong ball.

Warning, I didn't get any answer from the legal department, suddenly the problem just went away, like magic They don't want any bad press either and I'm sure they don't want people to suddenly realize there's a legal department and bombard them (hence, no response from them). It would have never occurred to me to think of it if my old boss hadn't mentioned it but it does make sense.

if you're military take this up with JAG.

I agree with perna, totally. It is not up to the hospital to decide who will or will not pay it. That is up to the insurance company and writing a polite but firm letter to them stating in a centred font "To whom it may concern" and then on the next line "Without Prejudice".

Then state your case and you can be assured that they will believe that you have already received legal instruction to ascertain your position. It will help your case even more if you have a letter from the insurance company stating that they have not been billed and so cannot assess the claim.

Best of luck with it, and though it's easy for me to say, please try not to stress as you work your way through this.

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Please speak with Tricare before believing the hospital.
Sometimes a hospital's billing and the insurance payment cross in the mail, so it could be that they have not yet received full payment, or they may not have submitted all the charges yet (even if the customer service rep thinks they did). Hospitals bill according to their billing cycle and sometimes late charges are posted after the initial billing, because they are discovered 'late', after the initial billing.

Another option, to make sure you are getting the correct information and that you understand the reasons, etc. is to contact the patient accounts supervisor for a full explanation.

Another option is to copy the bill you received and send it to Tricare with a note about your phone call, the date you called, who you spoke to, and what they told you. Ask Tricare to follow up on it.

A last option, and it works well, is to file a complaint with your state's insurance comissioner. Those complaints affect the insurance company's rating, must be handled quickly, and must the resolution must be approved by the insurance comissioner. Keep a copy of this complaint for yourself.

I hope this helps.

Sometimes hospitals have ombudsmen, who help patients with issues like this.

Very frustrating. Good luck to you.

Sorry to hear this Passport is doing the same to us. My husband was hositalized for 3 days back in 08 and we figured Passport paid for it never got a bill or statement about any charges. But Tuesday, we got a letter from the county attorney to pay $3,000 some dollars. I don't know what Tricare is but it sounds like gov insurance like Passport. I don't know what is going on

Thunderbear, Tricare is the insurance we have in the military.

Tricare sent us a letter. They sent a letter to the hospital, stating what has been billed and paid and that we have zero dollars liability. Now we'll see what happens. quite nice of Tricare to do that.

That is great news! It sounds like a misunderstanding or billing time frame issue.

You must be very relieved

I used to have Tricare, as my dad was in the military for 20 years. Tricare, although a very nice insurance, can be kinda messy and screw up a lot. As you have experienced. I've experienced having to call several people in the tricare office and hospital offices about bills that were supposed to be payed, weren't filed right, etc... but with patience, they will fix their mistakes. Good luck on everything, and i am glad to hear that you don't have to pay that bill. One time, i went to the psych ward for a week and the usual copay for tricare was around $240 (cause thats what i had to pay several times i went) and one of the bills came back and they expected me to pay over $9,000! :O It took me several WEEKS to get that one straightened out. Turns out they filed my visit as "outpatient" instead of "inpatient." It was so retarded. But a few months later, I got the correct copay bill. It just takes patience.

Wow thats crazy

May I respond to this? I personally believe this is a ploy by the medical and insurance industies to try and keep their profits high.

I've heard more and more instances of this through the internet and even in the local paper...where medical companies are billing and even harassing patients to pay bills they don't owe. Many people are not in any situation to assume they don't owe or fight the companies, and may, in their depressed state, just add it to bills unpaid pile.

I'm experienced this on my own, this past year, and I'm still not sure it's bee cleared up. The same story: hospital billing me for a bill that was already settled by the insurance company. Fortunately, my hospitalization insurance is with a company that sends ME a notice of what was billed, what they paid on my behalf and what, if anything I owe. I doubt I could figure all that out on my own without must stress! If I continue to receive calls or letters from the hospital, I'm turning them in to the FTC (Federal Trade Commission) who is cracking down on such illegal activity.

What the hospital (and doctor or whomever is billing you) needs is a declaration from the hospitalization/health insurance company that you don't owe it.

What occurs when you have insurance is this: the hospital or doctor has an agreement with the individual hospitalization/health insurance companies. They agree that if they charge xx amount, that if the insurance company pays/covers that element of billing, that the doctor accepts that as "full payment" and will not bill the patient. OR, they have an agreement that the patient will pay a percentage (deductible?) only and the rest the doctor has to write off.

Many doctors have increased their fees to try and cover their losses. The insurance companies won't pay any more than what was agreed, and the covered patient doesn't have to either...but the poor person (literally and figuratively) who has no coverage is stuck with the larger fee and thus is carrying the lack of full insurance coverage of all, on their backs. It's a failed system, imo.

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I'm glad I was a dependent back in the 1950's and 60s before all this outside insurance stuff. Glad Tricare got their act together. I fell Christmas Eve and had to go to the ER and several other doctors and we're still trying to get my bills and State insurance to sort it all out so we can pay our portion.