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  1. #1
    Join Date
    Nov 2015
    Posts
    2

    Default Denial of Payment of an Emergency Room Bill

    I was injured in 2008. All went well after hiring an attorney. Reached MMI, settled with future medical. Basically the doctors said they couldn't find anything wrong causing my level of pain.

    My original adjuster retired. The new guy denied an ED trip. The only one I have made in 7 plus years. Although I called my treating Doctor i wasn't able to speak with him. There was a block scheduled the very next day that was paid. Then In may I talked to my treating pain management doctor about a surgical consult to see what' options there were now. He ordered an MRI and appointment with the surgeon. Well it was the same guy as before. Then after 7 plus years the case nuse is reassigned to me (strange?) i see the surgeon that's rude asks me why I'm here, back and asks shouldn't this be closed? I said so how is any of that your concern? Your concern should be my medical care! Well he says he now has to go argue about ordering a Discogram. Well WOW! The test shows the 3 discs that has been the problem the entire 7 years caused by a 25 foot fall.

    The doctor that did my discogram is the same one that's done my 30 plus blocks. He gave me his notes and films. Well no follow up appointment with the surgeon that ordered the discogram. I called a week later and his assistant got on the phone and says they didn't find anything. I said REALLY? You SURE? I began reading the notes I was given. She became really defensive and said the doctor says no surgical option and says you've got other unrelated stuff going on too. I said he should be careful about what he writes. She asked why I said because my attorney is getting back involved. I feel like he ordered the discogram to disprove me. It backfired. So why wasn't it ordered in 2008? Please help me see what WC is up to.

    After 7 years there's a case nurse back long after we settled, a diagnosis now, (Finally)and my credit is now ruined because the ED bill for $2,666 has been turned over to collection. My credit was 822 when checked prior now it's 518. I see my attorney this week and I don't know what to expect. They are up to something. I'm suing them about the denial of the emergency bill for breach of contract if I can. When I got to the ED I insisted they must get approval before I can be treated.

    Well, 45 min later someone approved it. This is in the ED notes. All this started when my wonderful claims adjuster retired and this excuse for a man took over my case. He actually said file the denied bill on your insurance. I said so I should commit insurance fraud? REALLY?

    Please help with any info. You can. I know you guys have been down similar paths. Thanks for you guys help. This is all new to me as the first part of the dealings, settlement and care for my injury for 7 years was without event.
    Last edited by Stage2; 11-02-2015 at 08:15 PM. Reason: Spelling

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