Screwed over by hospital, insurance won’t do anything to fix it

Back on May 16 I got spine surgery as an emergency. Right before my surgery I got a notification by Rush Hospital saying that I needed to pay $6,352, which I immidiately paid to avoid any delays in my medical procedure. My out of pocket maximum is $6,600, which was automatically reached after paying that.

The timing in which all of my claims were processed by my insurance (UHC) was different to the information the hospital had when they billed me the 6,352. After UHC processed all of my claims, it turns out I only should have paid $1,510 for the surgery and about $4,800 for all of the other claims that I had prior to the surgery, so in other words, the hospital owes me about $4,800 and I owe the same amount to other medical providers.

It has been more than 3 weeks since my insurance processed the claim for the surgery and paid the hospital, so I now have a $4,800 balance in my favor that the hospital refuses to reimburse me. I called UHC and explained the situation. They cañled the hospital's billing department with me on the line and asked them to reimburse me the balance in my favor. The hospital states that it is against their policy to reimburse me my money because they claim that the insurance company owes them $600, which is not true because the insurer paid them the amounts that are on my explanation of benefits.

The lady from the insurance company tried to help getting my money back, but there was really nothing that she could do; it was her word against that of the hospital's billing department.

What legal actions do I have to get my money back? I need to pay the other providers and running very short on money due to other unfortunate life situations that I am going through.

This has been HELL. To think that I have to go through this after getting spine surgery is just insane.

Any advice would be greatly appreciated.

submitted by /u/Acklza
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