Auto Insurance Claims: Auto Insurance and Health Insurance Paid - Contractual Adjustment Apply?, health insurance company, health insurer

Question
Hi,
I was in an auto accident and have settled with the other driver's insurance company.  I have paid back my auto and health insurances for their expenses paid on my behalf.  My questions is about one provider who was initially paid by my health insurance and applied their contractual adjustment.  I submitted the remainder to the auto insurance who paid the original bill amount thus creating a credit balance.  The provider refunded the health insurance for their payment amount even though I had already paid them back and added back the contractual allowance amount to my bill.  They also refunded me for payments I made on the account. Now I have a balance on the account due to an error they made.  Can they take back the contractual?  My health insurance company says they have to honor the contractual adjustment no matter who paid on the account because it was filed with them and I am in their PPO network.  Any advice would be helpful.  I negotiated my settlement thinking that the contractual adjustment applied and this cuts into my future medical expenses amount.
Thanks,
Tim

Answer
Hi Tim,

You just need to write to them explaining the situation and telling then that your health insurer as said that they are required to apply the same discount. If they argue the point then you need to get your health insurer to intervene on your behalf.

Likely what happened is that all of the billing is computerized, so when they backed out the health insurance company the system restored the standard billing amount. You just have to get to sonmeone with a brain who can go in an make a manual adjustment.

I hope this helps
Richard Hixenbaugh