I have a problem with Baylor accepting the Insurance "Tricare Explanation of Benefits."
13 Mar 2013 I was involved in an automobile accident. It was suggested that I go to Baylor so I complied and went to the emergency room. GEICO my car insurance, at my request, payed my $2500 benefit to the hospital. Tricare Prime my primary insurance (Retired Military) allowed $1133.87 cents and paid $1103.87 with $30 that I would have as a copay. When the Government saw that Baylor payment the Judge Advocate took back the excess amount. I paid my $30 payment, Talked to many people in the department without resolve. 23 Dec 2013 I talked to Darren with a skelaton crew. He said he "understood the situation, didn't see why there was a problem, would put mu account on hold, and get back with me later because of the holiday week". I believed him. He didn't call back, I got a statement that said If I didn't pay the $15000 it would go to collections and all manor of bad things would happen. I contacted the BBB and Baylor told them they hadn't heard of me. I sent BBB a copy of my data and haven't heard back other than a return email acknowledging receipt. HELP. I am willing to pay my share but Tricare 3rd party billing says I don't owe and sent Baylor a copy and letter saying I don't owe. This is Baylor Centralized Business Services 2001 Bryan Street 2600 Dallas, TX 75201-3005 214-820-3151.
Bottom Line the insurance company used preexisting rules and Baylor doesn't want to follow.
Larry Rasmussen
Terrell,#2Author of original report
Fri, January 17, 2014
I have and had insurance. It just isn't honored.
Larry Rasmussen
Terrell,#3Author of original report
Fri, January 17, 2014
On March 13 2013 I had Tricare insurance (government) and Car insurance. GEICO (Car) paid $2500 personal injury and my personal insurance covered everything by my $25 per day or $30 whichever is more. However the Government insurance as a matter of practice uses all other insurance to pay for the costs first then pays whatever is left. However, with all insurance companies, they allow only a fraction of what is charged and the Medical officials/hospital/doctor must comply as a cost of doing business and the reward is a mass amount of business because it is the government. I have used Prespyterian Hospital in Greenvill many times with my family and myself over the last 14 years and a number of hospitals while in the USAF and civilian. Never have I had this type of behavior. Normally TRICARE will send a letter and the hospital complies, but this time two letters were not enough. Today, I spoke to a supervisor with some understanding and may get resolution. When I had a double bypass for heart in 1998 for well over a hundred thousand dollar bill I paid approx 200-500 for everything that included several days in the ICU and hospital. I had insurance, I have insurance, but I must still pay the full amount with insurance? I don't think that is right.
MochaG
Springfield,#4Consumer Comment
Fri, January 17, 2014
I am not so sure I understood the report exactly. Your report looks like a direct translation from another language. Here is my current understanding of your report.
1)You had a car accident on the 13th of March 2013.
2)You did not have a health insurance at the time you had the accident, so you went to Baylor and applied for an insurance? Or you already had a health insurance (Tricare Prime)? If so, why would you need Baylor? What was it for?
3)What is the total cost of you being hospitalized?
4)What do you mean by "Government saw Baylor payment, the excess money was taken back by the judge order"? Which government agency?
5)What is the "excess" amount? From what? In other words, who pay to who? And what are reasons for the payment?
6)What was the "problem" you were trying to resolve? What "department" you are talking about?
7)9 months later, you were talking to "skelaton" crew, what is this "skelaton crew" for?
Anyway, you at least need the record of what happened at the hospital (billing record). You also need what being paid and what not from all sources (hospital, your insurance companies, etc). BBB is not a mediator but a supposed to be "not-for-profit" organization (but I don't believe they are non-profit). Therefore, working with BBB won't help you solve the problem. You need to directly involve with all parties that involved in your car accident.