Workers Compensation Billing Dispute

Summary

A workers compensation claim was denied for a pre-existing condition, leaving the user responsible for medical bills. The user was billed without being asked for current insurance information, and their old insurance wont cover the costs due to the time lapse. Options include contacting the current insurance provider, filing an appeal with the former insurance, and filing a complaint with iowas insurance division.

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Workers compensation and my health insurance
Hi ****! Could you give me a bit more detail about your situation with workers' compensation and health insurance? For example, are you having issues with your claim, coverage, or something else?
In May *, i was at work when i randomly passed out. My manager called an ambulance and i was transported to the emergency room. I had some tests done in the ER and they scheduled me an appointment at a different hospital on another day to have a scan done on my heart. This appointment was scheduled at Kossuth County Regional. A few days go by and It was determined that it was a pre-existing condition. Workers comp would pay for my ambulance ride and ER visit. Anything after that would fall on me and my insurance. K.C.R finally sent me a bill LAST WEEK for the total amount. The bill stated i had no insurance. So i called K.C.R with my insurance information from last year and i was told by some lady that they recently learned that my claim was denied by worker's comp, so they looked at my file for my insurance information and since kossuth county regional isn't my normal hospital, they had nothing on file. I have more to say but I'm running out of space
Hey ****! Thanks for sharing the details. Did you provide your insurance information to Kossuth County Regional after the initial denial from workers' comp?
So instead of calling me and asking for insurance information, they sent me the bill for the entire total. They then said that my old insurance i had last year wouldn't cover anything because it was over 6 months ago. How is this legal? I did everything i was told to do! Its not my fault they took so long!
Case Rating: *
It sounds like a frustrating situation. Here are some general points to consider:
- Medical providers typically need current insurance information to process claims.
- Insurance policies generally have specific coverage periods.
- You could appeal the insurance company’s decision or file a complaint with Georgia's insurance commissioner.
Have you tried contacting your current insurance provider to see if they will cover the bills?
This happened almost a year ago. I've been on my wife's insurance for years, but they changed providers this year
Case Rating: *
It sounds like you may need to deal with both your former and current insurance providers. Here are a few things you could consider:
- Contact Current Insurance Provider: Ask if they can cover the bills since it was a continuation of care.
- File an Appeal: With your former insurance for the denial of coverage.
- Contact Georgia's Insurance Commissioner: To file a formal complaint.
Would you like more detailed steps on any of these options?
I live in Iowa...
Case Rating: *
Got it, ****. Given your situation in Iowa, here are some steps to consider:
- Contact Current Insurance Provider: Explain the situation and ask if they can cover the bills.
- File an Appeal: With your former insurance for the denial of coverage.
- Contact Iowa's Insurance Division: To file a formal complaint.
Would you like more detailed steps on any of these options?