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Notified that some local hospitals are taking crash victims’ health insurance information and then ignoring it, Loudoun, Fairfax & Leesburg injury lawyer Doug Landau believes that this is tantamount to fraud. One such hospital outright refuses to bill a patient’s health insurance, despite the fact that they obtain this information during the intake process, which fraudulently misleads the patient to believe that it will be billed – and that the billing will be timely. When the health insurance is not billed, the patient frequently is unaware of this and the submission deadline for health insurance may pass. When this occurs, the innocent patient is left holding the bag for the entire amount of the hospital bill !

The hospitals have a contract with each of the health insurance carriers. The contract sets the rates that the insurance company will pay for health care provided to its policy holders and their covered family members. The contract also requires the hospital to accept that insurance payment. People pay for health insurance so that they do not get hit with enormous medical bills. Some plans have deductibles or co-pays, but these are known ahead of time, when the policy holder buys the coverage.

The requirement that the hospital or doctor accept the previously agreed upon insurance reimbursement rate and not "balance bill" the patient is one of the main reasons a worker or their family would buy health insurance. Health insurance purchasers have a reasonable expectation that they will get the basis of that bargain between their insurance company and the health care providers. By not taking the insurance, the hospital is breaching their contractual obligation to the insurer. Find out tomorrow what happened to patients whose health insurance was not billed by the hospital…

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