The article says there was confusion because the baby was born right at the time when she was changing jobs and thus changing health insurance companies.
And it also indicates that both insurance companies paid.
There were apparently issues with refunding the credit balance on the patient account to the appropriate insurance company which overpaid.
I don’t fully understand hospital billing(does anyone?) but, this seems so absurd that this happened, if both insurers paid so there were overpayments on the patient account. It seems a simple process to refund the overpayment and zero out the account, not send a bill to the patient.
Medical billing is completely crazy, especially for preemies (been there, done that. Daughter is now a healthy adult). Preemie costs can reach in the high six figures (and, in some cases, over a million).
As much as we tried to stay current and figure out what we owed, we were always getting conflicting statements from the hospital and the insurance company.
Eventually, we thought everything was good. Then, about 6 months later, we received a notice that we overpaid, and then sent a check for the overage.
I held that money in my account for over a year before I touched it, in case they came back and said we owed. Fortunately, that day never came.
My father spent a lot of time in hospitals during his final years. Fortunately he had great insurance that covered almost everything. My brother nonetheless carefully checked the hospital billings that were received. On one he noticed a large charge for “special diet.” When he checked the date of the charge against Dad’s treatment he found that the charge correlated to a day that Dad was fasting for a medical test. The hospital was levying a charge for NOT providing meals!
Seems to be the hospital was quite happy double billing. Sounds like insurance fraud but the hospitals and insurers are so incestuous they will never admit the mistake. The hospital owes the money back to cigma.
Indeed, if that is the case then the hospital defrauded one or both insurance companies by accepting double payments, and the administrator responsible should be charged with that crime.
I once had two health insurance plans at the same time (2 full-time jobs with benefits) and I was told that using both for the same dental work (one for the work, one for the gold crown) was not allowed, I could use one or the other.