Insurance company actually helps out a client

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SlushboxTeggy

It's only stupid if it doesn't work
VIP
As a few of you know, I got jumped last August and wound up having to go to the hospital for a few stitches. It all went down on the last day I had coverage from my last job.

Well when all the paperwork went through it came up that I didn't have insurance and I got billed thousands of dollars from the hospital and the doctor who stitched me up.I contacted Aetna and they straightened everything out and I only had to pay ~$150. And I thought the issue was over.

I got a call the other day saying I owed $532.60. Turns out it stemmed from Aetna overpaying and recollecting funds from the actual doctor. I contacted Aetna ready to bitch someone out.

Actual message from Aetna
Your claim question
This is in response to your claim for date of service 07/31/2009 in the
amount of $1103.00 from XXXXX XXXXXX.

Your claim status
We reprocessed this claim since we originally did not apply the correct
negotiated rates per the contract. This claim was overpaid by $532.60
and we have requested those monies back from the provider.

Are you responsible for any charges?
Your total responsibility on this claim is zero.

We would be happy to contact the collection agency on your behalf.
Please provide a billing telephone number and an account number so that
we may assist you further.
I couldn't believe they are actually going to handle this for me.

So basically this doctor is trying to collect money from me I don't owe him. What a douche bag. I thought this guy was a prick before any of this. Let me provide that back story...

I go to the hospital around 3 in the morning. I had a decent gash right below my lower lip. It could have healed by itself, but I figured since I had insurance anyway, get a few cosmetic stitches. I get admitted to a room around 8am. I haven't slept at all at this point, so I fall asleep. I was not drunk. I wasn't drunk when I got in the fight a little after 2am.

The next part is from the account of my best friend who was in the room.

Doctor comes in. Doesn't acknowledge my friend. Sits down and gets started. I'm still asleep. My friend Gerald interrupts him and says, "Let me wake him up". Doctor says he can do it while I'm asleep. He goes to give me a local. Pokes the area with the needle and I jerk away. Does it again, and I jerk away again. My friend tells him again it will be easier to just wake me up. He disregards that and tries again. I jerk the opposite way and the needle goes completely through my lip. My friend pleads again and is disregarded again. Eventually he gives me the local and stitches me up, poorly.

Like I said, it was a small gash and I just wanted a few cosmetic stitches to reduce the scar. I got 6 stitches. Nothing. But because they were done so poorly I actually have more of a scar then if I hadn't gone to the ER at all. And now this guy wants money? Fuck yourself.
/rant.
 
File a formal complaint. There are so many hack doctors that need to be de-licensed
Now that I brought it to the front of my mind again I think I'm going to. And add that he's trying to collect money he is not owed.

Is it possible for me to get money out of him? I'm not a sue whenever possible person but it is truly a hack job and I'd like to have it fixed. I've had a beard since it happened because I'm so self-conscious about it.
 
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im confused. if Aetna over paid the hospital in the first place, why are they trying to get more money from you?
 
because they are pissed off that the insurance company realized their mistake and took the money back.
so instead of accepting the fact, they are trying to make the money back by making him think that he has to pay what the insurance company didnt owe in the first place.
 
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