Must a hospital in NJ inform me that a provider not participating with my insurance will treat me?

Asked over 1 year ago - Pomona, NY

Doctors are now balance billing for services my out-of network plan didn't cover. The hospital is in-network but dr's weren't. I feel I should have been informed.

Attorney answers (1)

  1. Peter Christopher Lomtevas

    Pro

    Contributor Level 20

    Answered . No. A hospital in New Jersey can be in-network for insurance purposes, but specialists performing individual items of work can be out of network and can balance bill you. That being said, I don't know your particular facts and I must guess. You went in for heart surgery at a hospital that is in-network for your insurance. A cardiologist specializing in a certain facet of your heart had to be consulted, He charges $500 for that consultation. The surgery is all covered but the $500 bill arrives at your door.

    Otherwise, balance billing is very illegal in New Jersey. An in network provider cannot accept a payment from you insurer and then send you a supplemental bill for additional funds.

    Good luck.

Related Topics

Divorce

Divorce is the process of formally ending a marriage. Divorces may be jointly agreed upon, resolved by negotiation, or decided in court.

Divorce and health insurance

During divorce, courts usually require spouses to maintain the status quo regarding their health insurance and keep the same policy.

Can't find what you're looking for? Ask a Lawyer

Get free answers from experienced attorneys.

 

Ask now

30,344 answers this week

3,392 attorneys answering

Ask a Lawyer

Get answers from top-rated lawyers.

  • It's FREE
  • It's easy
  • It's anonymous

30,344 answers this week

3,392 attorneys answering