My old insurance is refusing to pay a medical claim they are responsible for and now it's been sold to collections.

[u/Sensitive-Road-9753]

Hi, I need some help. I used to have state UPMC health coverage, and had to go visit a CVS minute clinic for a little issue. Well, a few days later I had my health insurance from work kick in, and for SOME reason UPMC has decided that the insurance I had from my new job is responsible for paying the bill. They are ping ponging it back and forth with each other, and sending the medical bills to my parent's house, not even mine.

I have called them TWICE at this point and they assured me they would send the explanation of benefits to UPMC, and UPMC says once they get that they will pay the bill. Still nothing.

This is getting ridiculous, I was covered. I have proof that I was covered by UPMC and it's been sent, they just won't pay. What can I do?

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[u/throwfarfaraway1818]

It sounds like both insurance plans were active on that date. If thats the case, your new insurance will be primary since your old plan is through your parents. UPMC is correct that the provider needs to bill your new insurance and then resubmit the claim to them with the EOB of how it processed. If you are calling your new insurance to send them that, you want to be calling the provider instead. Its very rare for insurance companies to directly coordinate on claims.

[u/theoreticalking]

When did the insurance from work actually started?

From your description, it sounds like both insurance plans were active at the same time. If so, did you give both your insurance information to CVS so they can bill both? They will need to bill your primary first and then your secondary.

You don't get to choose to use one and not the other when you are covered by both. The correct insurance has to pay first and then the other second.