Do I have to pay medical bills incurred because of an injury caused by a doctor? - Accident Law Questions and Answers- LawQA.com

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Do I have to pay medical bills incurred because of an injury caused by a doctor?

I went in for a routine colonoscopy due to being a high risk. Polyps were removed. That evening I ended up in the emergency room. The doctor had burnt my intestines during the removal. That doctor and the hospital are now billing me for that stay. Do I have to pay those charges? Also I started receiving bills for the colonoscopy a month later, only to find out the doctor submitted the wrong code to the hospital. He billed it as medical instead of screening. Supposedly this was fixed after several calls to his office, however 6 months later I am still battling with the insurance co. because they refuse to pay for all of it saying it was submitted as medical. I have submitted an appeal with the insurance co. What recourse do I have if they refuse to pay for the colonoscopy part of it?

Law Office of Travis Prestwich, PC
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You should speak to the doctor that performed the surgery and work through a plan to get the right amounts billed and paid. Medical malpractice claims can be, and frequently are, complicated. This probably is not the type of case suitable for a malpractice claim. Your doctor's billing office should be willing to sit down with you and figure out what needs to be fixed and how to do it.

Answer Applies to: Oregon
Replied: 6/28/2011

Answer By Luke T. Pepper
LT Pepper Law
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You may have a case here. We would need to evaluate the medical records to determine whether the doctor was negligent when he performed the procedure. You should consult with an attorney before you approach the hospital about who is responsible for the bills.

Answer Applies to: Pennsylvania
Replied: 6/28/2011

Riley Law Firm
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The fact that the condition occurred during a colonoscopy does not relieve you of the obligation to pay the bill for the repair. You may have a claim against the physician but perforation of the colon is one of the known potential risks of the procedure which can occur even if the physician does everything correctly. Accordingly, they are exceedingly difficult cases to pursue. On the medical insurance, if your health insurance was provided by your employer (most cases), your options are limited by application of the Employee Retirement Income Security Act (ERISA). You would have to follow the administrative provisions of an ERISA appeal. If it is privately purchased health insurance, you would have more options under the laws of most states. You should consult an attorney in your state with specific expertise in this field.

Answer Applies to: Texas
Replied: 6/27/2011

The Lucky Law Firm, PLC
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Thanks for your inquiry. This information is being provided to you based on Louisiana law. Yes, the medical bills still remain outstanding. However, you may make a claim for the medical bills to be paid; however, you will have to bring a claim under the Medical Malpractice Act. Unfortunately, dealing with the insurance company is another story. I would also have the doctor's billing office discuss the charges and the coding with the insurance company. This is a process that is tangled with red tape and usually just requires that you follow the process - although, it is incredibly frustrating. Please contact my office to discuss further. I am happy to discuss all of the issues with you in more depth.

Answer Applies to: Louisiana
Replied: 6/27/2011

Paul Whitfield and Associates P.A.
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Sorry. question is not clear to me. If you think the Dr made an error you must show that by the testimony of another doctor. The problem with billing codes is unclear.

Answer Applies to: North Carolina
Replied: 6/27/2011

Answer By Lacy Fields
Lacy Fields, Attorney at Law, LLC
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That sounds like medical malpractice and you should consult an attorney immediately. You only have two years to file a lawsuit, and you need to get the right kind of treatment immediately. Sometimes if you do not handle these things the right way, the insurance company can make it look like the injuries are actually your fault.

Answer Applies to: Missouri
Replied: 6/26/2011

Vincent J. Bernabei LLC
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You may have a medical malpractice claim against the doctor.

Answer Applies to: Oregon
Replied: 6/26/2011

Answer By Josh Lamborn
The Law Office of Josh Lamborn, P.C.
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You can refuse to pay, but unless you use their procedure for challenging a bill, they will likely submit your bill to a collection agency and ruin your credit rating.

Answer Applies to: Oregon
Replied: 6/26/2011

Answer By Jared Altman
Law Office of Jared Altman
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I am not an expert in health insurance claims. But, it seems to me that if the doctor made an error in the way he/she billed something, then the doctor should eat the loss if insurance doesn't pay. I think that's a great argument, but I don't think that it will hold up in court. Certain injuries and/or side effects are known risks of various procedures. If you suffered a known risk, then you have no recourse. If, on the other hand, the doctor committed medical malpractice on you (which only another doctor of his/her specialty could tell you), then "no", you don't have to pay. Please note the following necessary legal disclaimer: I have not given legal advice. I only give advice to my clients. I am not acting as your attorney. I have not yet agreed to represent you. Anything I have said is based on limited information and may be subject to change as more facts become known. Attorneys express opinions. Attorneys often disagree. If you want further information or independent verification of anything I have said then you should immediately consult another attorney. Never sit on your rights! I am admitted to practice law in New York State only and cannot practice law in any other State.

Answer Applies to: New York
Replied: 6/25/2011

Cody and Gonillo, LLP
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If you are looking to sue for malpractice you have to get the opinion of another medical professional that this set of facts gives rise to a malpractice claim - you should consult with a medical malpractice attorney in your area.

Answer Applies to: Connecticut
Replied: 6/25/2011

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