Is my Health Insurance entitled to reimbursement?

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Jidenavtil91
Posts: 1
Joined: Tue May 31, 2016 11:19 am

Fri Jan 06, 2017 8:37 am

Hi,
I was slammed into by a driving texting on their cellphone 8 months ago. I recently settled my case after completing a few months of treatment including physical therapy. My health insurance plan, BCBS, has all along been sending notices that if I recover from the accident, some of that may be due to them for reimbursement. Yesterday, I got their final number and a list of all the charges they are asking for reimbursement for and I see a few items that I don't believe should be there. While i was getting phsyical therapy for my back for the accident, i also had a sports injury about 3 months ago that required physical therapy on my shoulder. I got this done with the same doctor but it is not related to the injuries i got from the car accident. How do I contest these charges?

Thank you,
Jiden

Richard Dingus
Posts: 66
Joined: Mon Feb 22, 2016 10:48 am

Wed Jan 25, 2017 10:10 am

Thanks for the post, and great question.

In order to contest charges for treatments that are not related to injuries sustained in your car accident, you should first contact your health insurance company and let them know about the dispute. A point of contact should be listed on the letter explaining your health insurance final claim for reimbursement. Furthermore, you will want to make a copy of the listed charges and mark through (strike) those charges that you feel are not related. You will also need to attach an explanation as to why each date of treatment is not related to the accident. Be sure to forward the information to the point of contact previously mentioned above.

Finally, if your health insurance refuses to remove the disputed charges, it may be a good idea to have your doctor write an explanation as to the reason for your medical treatment.

Thanks again for the post, and I hope this helped.
Richard Dingus
Attorney and Counselor at Law

• Durham • Raleigh • Greensboro

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