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    tinc31's Avatar
    tinc31 Posts: 7, Reputation: 1
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    #1

    Oct 15, 2008, 06:49 AM
    How do I file an answer in defense?
    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
    ScottGem's Avatar
    ScottGem Posts: 64,966, Reputation: 6056
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    #2

    Oct 15, 2008, 06:56 AM

    Can you give us more details? Are you being sued over a medical fee you haven't paid or what?
    tinc31's Avatar
    tinc31 Posts: 7, Reputation: 1
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    #3

    Oct 15, 2008, 06:58 AM

    The insurance co paid the surgeon the allowable amount . He is balance billing more to us directly.
    ScottGem's Avatar
    ScottGem Posts: 64,966, Reputation: 6056
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    #4

    Oct 15, 2008, 07:04 AM

    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.
    tinc31's Avatar
    tinc31 Posts: 7, Reputation: 1
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    #5

    Oct 15, 2008, 07:09 AM

    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%
    ScottGem's Avatar
    ScottGem Posts: 64,966, Reputation: 6056
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    #6

    Oct 15, 2008, 07:45 AM

    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.
    tinc31's Avatar
    tinc31 Posts: 7, Reputation: 1
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    #7

    Oct 15, 2008, 07:47 AM

    OK my original question how do I file an answer in defense myself. I don't want to pay an attorney
    ScottGem's Avatar
    ScottGem Posts: 64,966, Reputation: 6056
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    #8

    Oct 15, 2008, 08:04 AM

    This is small claims court, generally attorneys are not allowed. Also they are less formal. A simple letter as I outlined, will suffice.
    tinc31's Avatar
    tinc31 Posts: 7, Reputation: 1
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    #9

    Oct 15, 2008, 08:06 AM

    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
    ScottGem's Avatar
    ScottGem Posts: 64,966, Reputation: 6056
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    #10

    Oct 15, 2008, 08:39 AM

    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.
    tinc31's Avatar
    tinc31 Posts: 7, Reputation: 1
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    #11

    Oct 15, 2008, 08:41 AM

    Yes we already had a hearing court date set for December
    JudyKayTee's Avatar
    JudyKayTee Posts: 46,503, Reputation: 4600
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    #12

    Oct 16, 2008, 07:17 AM
    Quote Originally Posted by tinc31 View Post
    yes we already had a hearing court date set for december


    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.
    tinc31's Avatar
    tinc31 Posts: 7, Reputation: 1
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    #13

    Oct 16, 2008, 08:24 AM

    OK thanks
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