Could use some advice... Seems like I may be c"v getting screwed in an insurance situation.
My wife is on her parents insurance (let's call insurance A) and was on it when we first got married, then for the first year or so while she was in school. She then graduated and B"H got a job which gave her insurance, incidentally her work provided her with the same exact insurance and even the same plan name (thought the benefits were slightly different, more or less all matched up).
We didn't think much of it, and kept using for her the insurance card from her parents, as we figured she could just use which insurance she wanted to, and they were the same anyhow.
Comes this january, and her company switches insurances to "Company B". Company B is a completely different company. Not thinking much of it, we keep using her parents insurance for her, as that just seemed simpler then updating all her doctors with the new insurance, married name etc...
All seemed to be going well, had a baby B"H and B"AH all her bills were paid.
Now, we get a call from her OB, that insurance A (her parents insurance) demanded payment back from them (only from January 1st and on though) - due within 30 days?!?!
(reason given as they were falsely billed as the primary insurance, while PT has insurance from work that should be considered the primary)
So, I started researching based on what I heard from the OBs billing person and found a few crucial pieces of information that we did not know...
Apparently there is a concept of Primary vs Secondary Insurance - Based on my wife having insurance as a dependent (her father's insurance) and from her work - her work should always be the primary... And the solution to coordinate between the two is by filing a COB (coordination of benefits) to both companies, and having them figure out what the primary and secondary will cover etc...
Who would have thought... We thought you can use whichever you want... Both are being paid for.....
So now - what do we do???
C"V Insurance A can technically go back 18-24 months (NY/NJ) or even possibly unlimited (by saying the DR billed wrong as DR stated they were the primary) and then DR can demand a refund....
B"H the new company has a 12 month window for in network, and 18 month window for out of network, but how do we protect ourselves if they C"V decided to do this to the hospital/other doctors in a year or more from now?
TIA.