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La Tour/Hospital invoices- accident insurance

Hi all,


I hope someone would be able to offer some advice.


I have an issue regarding an hospital invoice that has somehow appeared after some years. This, it turns out, is because my accident/work insurance has not decided not to cover my treatment. When I've contacted them it is because I ended up in a private room, supposedly (privee complementaire) and thus outside my work's coverage. The insurance did pay for my diagnosis, and post-treatment and incapacity wage etc.


Now my work, who was organising the paperwork on my non-French-speaking behalf told me everything was covered, as I was unsure if I would be eligible for La Tour. Now that person who was signing things of my behalf has now left the organisation/company.


The hospital, who I haven't contacted yet, did not mention to me at the time any additional costs, and I did not knowingly ask for anything outside my coverage, nor was it ever explained to me.

Any ideas on who I should explain my plight too, or does anyone know the general procedures here?


 

The text you are quoting:

Hi all,


I hope someone would be able to offer some advice.


I have an issue regarding an hospital invoice that has somehow appeared after some years. This, it turns out, is because my accident/work insurance has not decided not to cover my treatment. When I've contacted them it is because I ended up in a private room, supposedly (privee complementaire) and thus outside my work's coverage. The insurance did pay for my diagnosis, and post-treatment and incapacity wage etc.


Now my work, who was organising the paperwork on my non-French-speaking behalf told me everything was covered, as I was unsure if I would be eligible for La Tour. Now that person who was signing things of my behalf has now left the organisation/company.


The hospital, who I haven't contacted yet, did not mention to me at the time any additional costs, and I did not knowingly ask for anything outside my coverage, nor was it ever explained to me.

Any ideas on who I should explain my plight too, or does anyone know the general procedures here?


 


Ally HFeb 10, 2014 @ 14:14
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Re: La Tour/Hospital invoices- accident insurance
Post 1

When you have a problem with a hospital bill, always contact that hospital office first. They should advise you what to do. Also, ask for someone who speaks English if you do not know French. Always write down the info. (such as whom you spoke with, date and time, what number you called or they gave you.....) for each of your contact for your record.  Always put to writing. The same with your company when you contact them.  

The text you are quoting:

When you have a problem with a hospital bill, always contact that hospital office first. They should advise you what to do. Also, ask for someone who speaks English if you do not know French. Always write down the info. (such as whom you spoke with, date and time, what number you called or they gave you.....) for each of your contact for your record.  Always put to writing. The same with your company when you contact them.  


Jen C, Feb 10, 2014 @ 15:00
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Post 2

Jen,


Thanks for the quick reply- that would be my plan, and to see a solution out of it.


Out of interest, should the hospital have told me about extra costs, or to check my eligibility with the accident insurance instead of given me extras beyond my coverage?


They certainly didn't tell me about either- I certainly wouldn't have signed up otherwise, and I would've thought a private hospital would be quite strict on these things.


 


 


 


 

The text you are quoting:

Jen,


Thanks for the quick reply- that would be my plan, and to see a solution out of it.


Out of interest, should the hospital have told me about extra costs, or to check my eligibility with the accident insurance instead of given me extras beyond my coverage?


They certainly didn't tell me about either- I certainly wouldn't have signed up otherwise, and I would've thought a private hospital would be quite strict on these things.


 


 


 


 


Ally H, Feb 11, 2014 @ 09:42
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Re: La Tour/Hospital invoices- accident insurance
Post 3

Hi Ally! I am not a professional in this field, I just want to offer you some thoughts based on my own experience. Normally the hospital would verify with your insurance. In my case, when I was hospitalized several years ago, at first, the hospital put me in a room with several patients. Then they found out that my insurance could cover semi-private room, so they switch me to a room with another patient, just the two of us. So, from my experience, I would say the hospital knows what they do. I wonder in your case, maybe it just happened that they did not have other patients to share with you and you were just lucky to have a private room or semi-private room, but then the hospital wanted to charge your insurance for that to get paid more.....? You should ask them, and insist that you were not informed about this......

The text you are quoting:

Hi Ally! I am not a professional in this field, I just want to offer you some thoughts based on my own experience. Normally the hospital would verify with your insurance. In my case, when I was hospitalized several years ago, at first, the hospital put me in a room with several patients. Then they found out that my insurance could cover semi-private room, so they switch me to a room with another patient, just the two of us. So, from my experience, I would say the hospital knows what they do. I wonder in your case, maybe it just happened that they did not have other patients to share with you and you were just lucky to have a private room or semi-private room, but then the hospital wanted to charge your insurance for that to get paid more.....? You should ask them, and insist that you were not informed about this......


Jen C, Feb 11, 2014 @ 10:09
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Re: La Tour/Hospital invoices- accident insurance
Post 4

Hospital is best bet.  When I was there after an accident and of course had no idea what cover I had, they contacted the insurance on my behalf before operating etc

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Hospital is best bet.  When I was there after an accident and of course had no idea what cover I had, they contacted the insurance on my behalf before operating etc


Paul E, Feb 11, 2014 @ 11:52
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Re: La Tour/Hospital invoices- accident insurance
Post 5

I agree to what Paul has said. It is almost the hospital responsibility to check with the insurance company. What happens if the patient is unconscious? You should let the hospital and the insurance company work out this problem, who takes the responsibility for this unpaid coverage? Why it happened at the first place?  

The text you are quoting:

I agree to what Paul has said. It is almost the hospital responsibility to check with the insurance company. What happens if the patient is unconscious? You should let the hospital and the insurance company work out this problem, who takes the responsibility for this unpaid coverage? Why it happened at the first place?  


Jen C, Feb 11, 2014 @ 14:10
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Re: La Tour/Hospital invoices- accident insurance
Post 6

Paul, Jen- many thanks for your replies- it's very much appreciated!


I shall drop the hospital a line tomorrow or Friday, and hopefully something favourable will turn out!


Wish me luck :)

The text you are quoting:

Paul, Jen- many thanks for your replies- it's very much appreciated!


I shall drop the hospital a line tomorrow or Friday, and hopefully something favourable will turn out!


Wish me luck :)


Ally H, Feb 12, 2014 @ 16:20
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