In network provider filed claim with UHC late and provider wants student to pay $1990. This is in IL.
In network hospital emergency visit for two consecutive day on Oct 2023 was billed
to Anthem BCBS which was approved on Oct.
UHC student insurance card arrived at out-of state parent address instead of student
address.
Hospital portal had an error to update UHC insurance card information, multiple calls
with no help, after 2 months with persistent calls and emails to patient relations,
one representative asked the patient to send the card information by email to her, and she
updated the hospital portal.
Hospital then submitted a claim to UHC which was received by UHC on March 3rd 2024.
Of the 4 claims, UHC denied 2 claims due to late filing though it was a day apart.
Since UHC student insurance takes precedence over parents insurance, Anthem on April 2024,
denied the originally paid claim to hospital (per hospital) making the balance unpaid.
1. If primary insurance did not pay, then should secondary insurance not have picked the tab?
2. March3rd 2024 UHC denied, and April 24 Anthem BCBS asked the hospital to pay the money back.
Hospital/provider could have updated Anthem about the situation so Anthem could process or,could have asked UHC to process the claim with reasons for late filing , neither of which was done. 3. Anthem BCBS has no statement which mentions it paid back the money to the hospital, and on phone(only option to reach Anthem BCBS) to Anthem BCBS representatives keep denying it.
4. Hospital/provider refuses to submit a claim to Anthem BCBS, with details from UHC denial.
5. Hospital/provider refuses to ask UHC to consider it by providing a reason for late filing.
6. Anthem portal clearly states in-plan claims must be submitted through provider,
Anthem BCBS has no emails to send the details
This has been ongoing for an year. Now it s Oct 2024, and both Anthem BCBS and provider are not willing to do anything.And now the hospital/provider has the money of $1990 to debt collection.How can an in-network late filing by provider be billed to student especially when hospital/provider are doing nothing to get it processed on time.This is in College campus at UIUC , IL.
Any help with regards to it, on how to follow through, would be greatly appreciated.
