I need to dispute a medical claim . I have the bill of particulars. Now I need a an answer in defense. How and what do I do? In live in Virginia

Can you give us more details? Are you being sued over a medical fee you haven't paid or what?

The insurance co paid the surgeon the allowable amount . He is balance billing more to us directly.

What does your coverage entail? If your insurance coverage was for R&C (reasonable and customary) you are generally responsible for any overage. The only way you wouldn't be responsible is if the surgeon was part of a PPO or HMO where they agreed to accept whatever the carrier paid.

Generally, when you are responsible for the practioner's fee over and above what the insurance pays, you sign such an agreement when you start treatment.

We are part of an HMO .this was a trauma case, and he was brought in. no one ever informed us or asked us about his billing etc.. The hospital said we were covered 100%

Ok, then that is your defense. Respond to the summons stating your Intent to Defend against the suit. State that you are covered under an HMO and were told that you were covered 100% (after a deductible? ) for any services provided.

OK my original question how do I file an answer in defense myself. I don't want to pay an attorney

This is small claims court, generally attorneys are not allowed. Also they are less formal. A simple letter as I outlined, will suffice.

We got a warrant of debt. Do I just send the letter to the attorney who sent it? Do I file it with the court

What does the warrant actually say? Anything with respect to the suit would be filed with the court clerk with a copy to the plaintiff.

Yes we already had a hearing court date set for December

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Originally Posted by tinc31

yes we already had a hearing court date set for december

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Scott has it covered - original to Court, copy to Attorney, get delivery signatures on both. Make sure you are within the time frame to respond.

OK thanks