health care coverage dispute

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Posted by Diane Wallis (216.60.46.40) on May 06, 2003 at 09:06:00:

On 9/30/02 I went to the emergency room at Harris HEB. HEB Emergicare PA billed United Health Care(my provider) for $292.00. UHC paid $270.00 and disallowed $22.00 as part of the main procedure. HEB Emergicare has sent this to collection and I am getting nasty letters concerning the $22.00 charge. I have been round and round with both UHC and HEB Emergicare concerning these charges. HEB Emergicare keeps insisting that their doctors are not covered providers so I am responsible for the portion not paid by UHC. I spoke with UHC about this to try to determine why if I went to their provider hospital, the doctor wasn't covered. They told me the charges were billed incorrectly, not as emergency charges. I contacted HEB EMergicare about this and was told the only thing they bill for is emergency care so it was billed correctly. I called HUC back ans was told that the charges were considered part of the main procedure and were not allowable. They claim that HEB Emergicare cannot bill me for these charges. HEB Emergicare insists they can and refuse to pull them from collection. They told me if I doubted them, I should contact the Texas Dept. of Insurance. This is really going to become and issue because I have another emergency room visit from 2/11/03 that is headed in the same direction with $34.00 unpaid. I don't want to ruin my credit history, but I also don't want to pay charges that they shouldn't be billing. Can you help me ?


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