Is it the patient’s responsibility to file a corrected claim on behalf of hospital?
I received care with an in-network provider. But there was a problem with one of the claims submitted by the hospital (coding and double charging). The hospital agreed to re-submit a corrected claim, but it was denied again, this time for incorrect insurance information.
I’m being ping-ponged between the hospital’s billing department and the insurance company. They are failing to communicate with each other. Each side keeps asking me, the patient, to follow up with the other side. But they refuse to share the claim and EOB paperwork so I can figure out whose at fault or what went wrong.
The hospital says they submitted the claim correctly but received an EOB with a denial (which they refused to share with me). My insurance, on the other hand, says wrong insurance information was submitted, which led to claim denial. Neither side is sharing any further details with me.
The hospital is saying they only re-submitted the claim as courtesy, hinting that I should be the one submitting the corrected claim. They are threatening with collection.
I may understand the idea of a patient submitting a fresh claim. But if it’s a corrected claim, how can the patient be responsible for following up on something that was not their fault to begin with? I was not the one starting the claim process, so how can I be the one responsible for fixing something when I don’t know what went wrong exactly?
Is it legally the patient’s responsibility to correct a claim that was wrongly processed by the hospital?