2 Insurances, No Coverage

(WSVN) - She had insurance from two providers, and when the bill came for her baby’s birth, guess who was told had to pay? Yep, the parents. And when they couldn’t sort through this medical pain in the behind, they called Help Me Howard with Patrick Fraser.

Every baby is cute, but Jamison is really adorable.

Lowiss Belorne, two insurances and no payment: “My sunshine.”

The 5-month-old is Lowiss’ first child, and talking about him still chokes her up.

Lowiss Belorne: “Loving, caring, the reason I get up for every morning.”

Jamison makes Lowiss smile. The bill for his birth leaves her steaming.

Lowiss Belorne: “No, it doesn’t make any sense to me.”

When Lowiss got pregnant, she had just started a new job and did not have health insurance yet, so she applied for Medicaid and got it.

Lowiss Belorne: “I was told, when I had to go to my doctor’s office, whatever procedure, I had to show my Medicaid card, and that’s what I did. Every time I went to my doctor’s office, I just showed my Medicaid card.”

Soon, Lowiss’ insurance from work kicked in, but she did as she was told and showed her Medicaid card.

Lowiss Belorne: “Even though I had Cigna as well.”

Then Jamison was born, and with that, she and her husband got a bill.

Lowiss Belorne: “Four-thousand five-hundred dollars for the prenatal care and the delivery of my son.”

Lowiss contacted Medicaid and asked why they had not paid the bill.

Lowiss Belorne: “Medicaid said no because I had Cigna which is my primary, so Cigna should pay first.”

Lowiss contacted Cigna insurance. They said your doctor has not billed us, so Lowiss contacted them.

Lowiss Belorne: “They told me that because I did not show my Cigna card when I first came to the office, and due to untimely filings, they cannot submit the claim and I am responsible for the bill.”

Lowiss has two insurance providers, but she is being told she has to pay the $4,500 doctor’s bill because it’s too late to bill her primary insurance company for it.

Lowiss Belorne: “It doesn’t make any sense to me. I personally feel I am being punished because I didn’t show my card.”

Well Howard, is Lowiss stuck paying this $4,500 bill?

Howard Finkelstein, 7News legal expert: “No. Since Lowiss has two policies, one way or the other she is covered. And since the doctor’s office doesn’t want to bill her insurance company, Lowiss needs to contact them and find out what the problem is, or in her case, we will do it for her.”

I contacted the doctor’s office, and they told me Lowiss would have to pay that money because she did not tell them she had Cigna Insurance, and Cigna would not pay because they waited too long to bill them.

I then contacted Cigna. They called their response prompt, but I would call it lightning quick.

That day Cigna spoke to Lowiss, and her doctor’s office and wrote us, “The claim has now been submitted by her doctor and is currently being processed. Our customer service team is pleased to have provided a prompt resolution.”

Howard Finkelstein: “If you have more that one type of insurance, like a private policy and Medicare or Medicaid, always provide all your insurance information to the doctor or provider to avoid confusion, delays, and denials of coverage.”

Lowiss Belorne: “It feels awesome, liberating. Trust me, it does.”

Lowiss’ insurance headache is gone because she listened to her father.

Lowiss Belorne: “I felt intimidated and scared, and I didn’t know where to run to. And my father told me, ‘I think you should call Help Me Howard.’ He watches Help Me Howard every weeknight.”

Never too old to listen to your father. Now, dealing with medical bills can be a true headache. In our case, we found the right person at Cigna who got the doctor’s office to work with them. If you have an insurance problem, keep trying different people until you find the one who can straighten it out, or when all else fails, contact us.

Given birth to a problem that’s growing out of control? Don’t baby it. Contact us — so we can insure you get all the help you need.

Email: helpmehoward@wsvn.com
Reporter: Patrick Fraser at pfraser@wsvn.com
Miami-Dade: 305-953-WSVN
Broward: 954-761-WSVN

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