• My hospital won't release a copy of the UB 04 (itemized bill)to me or AFLAC. AFLAC won't pay without this. Does anyone know what I can do?

    Asked by magdem on Friday, October 5, 2012

    My hospital won't release a copy of the UB 04 (itemized bill)to me or AFLAC. AFLAC won't pay without this. Does anyone know what I can do?

    17 Answers from the Community

    17 answers
    • teddyfuzz's Avatar

      There is no reason that I can think of as to why they shouln't release this to you. They want you to pay for your treatment, don't they? Why would you pay for something that you can't review? Tell them that if they want to get paid, they need to give you an itemized statement of your account. If someone tells you "no", thank them for their help but say that you really need to get this resolved and ask to speak to their supervisor or manager. Also, make sure you are documenting the names of the people you speak with. Good luck!

      over 8 years ago
    • FreeBird's Avatar

      If the appropriate office at the hospital is uncooperative after explaining that the insurance company requires an itemized bill in order for them to receive their money, I would try contacting hospital administration, then try to utilize your state resources. http://www.tdi.texas.gov/CONSUMER/cpmbalancebilling.html

      You received good tips on recording names of people you talk to. Get someone else to help you if you can. There's no good reason someone who is sick should have to be put through the beaurocratic circus.

      The next thing I would do is relax, and don't worry about it. It will work out one way or another.

      over 8 years ago
    • FreeBird's Avatar
    • carm's Avatar

      Hello, I might be able to help you. I am an oncology/end of life nurse and this is not the first time I have heard of this with AFLAC. It usually has to do with the release of the medical record. Might I suggest that you go to your hospitals medical records department and ask to sign a medical record release form that authorizes AFLAC to get that record? Once you sign it, ask for a copy and keep it in a safe place in case the hospital claims they can't locate the form you signed, or AFLAC states they can't get the UB 04. I would also ask for a copy of the UB 04 for yourself. Just in case, so that you could forward to AFLAC in case the medical records department doesn't, they have to release to you...how else do they think they will be paid? If they tell you they cannot give the form to you then simply tell them you will not pay for anything without a bill. These records are your personal records. Sometimes you have to sign a release to authorize the hospital to share the information with a third party and this seems to be the case when it applies to AFLAC for some reason. If this does not work, I would ask the hopital to assign a case manager to you and let them sort it out. I really hope this helps you. Good luck, Carm.

      over 8 years ago
    • geekling's Avatar

      Just stay out of it. Should someone dun you or bother you from the hospital, politely said they need to contact your insurance company if the hospital wishes a payday. If needs be, threaten to contact an appropriate consumer protection agency as well having a discussion, regarding this unnecessary threat (stress) to your recovery, with your good buddies, your attorney and the media.

      over 8 years ago
    • huckster's Avatar

      A ub04 is a form a hospital uses to bill the insurance company. It is NOT an itemized bill. The hospital may release the form to an insurance company but they do not typically release it to a patient. The reason they may not release it to AFLAC because AFLAC is not listed on your account as an insurance company that you have. Check with Medical Records at your hospital and sign a release to give authorization for AFLAC to see your UB04. Next have AFLAC call your Business Office. It could be a stall tactic by AFLAC.

      over 8 years ago
    • Coolgm's Avatar

      When you were admitted one of the things that a hospital requests from you is your ID & insurance card and they have you sign a release of information. Did you give them the AFLAC CARD? Or is AFLAC a secondary. The billing department of hospitals are very adept at billing & collecting so they are not going to hinder any efforts at getting paid. my question is why are you involved? You have enough to worry about. Let the hospital do their job. Believe me they are going to make every effort to get their money. If you want a copy than you have every right to it. I'm sorry for your illness & wish you the best in your recovery.

      over 8 years ago
    • Carol-Charlie's Avatar

      Send a Registered Letter to the hospital Accounting Office stating until they supply you with an itemized bill for the UB 04 treatment. They will not be paid. Copy the Hospital CEO and your Lawyer.

      over 8 years ago
    • LuvinSis' Avatar

      I'm guessing you have regular health insurance that pays to the hospital/providers (which hospital has on record) and AFLAC policy is supplemental /critical illness / cancer policy that you must file and money is paid to you. Since AFLAC isn't listed as your health insurance company on hospital records the hospital is hesitant to release to them. As someone said, contact medical records dept of hospital and sign an authorization. Bring a letter, from you, stating you need itemized bill for AFLAC policy which pays money directly to you for medical costs. Confirm with AFLAC if that's all they need as they may require ICD9 (diagnosis) and/or CPT (treatment) codes or other explanatory records.

      over 8 years ago
    • ruthieq's Avatar

      If they won't release it to AFLAC I can't imagine how they plan to get paid...If they won't do it, call the patient advocate office, then call a lawyer if they still won't release it. You are entitled to a complete detailed bill about your stay. Period

      over 8 years ago
    • cjs7159's Avatar

      Ask your doctor or hospital social worker if he/she can assist you with this. Sometimes a call from the doctor can make the hospital more apt to cooperate. You do have a right to an itemized bill, I have no idea why they would not release it to you. Good luck.

      over 8 years ago
    • LuvinSis' Avatar

      I think there's still some confusion so I wanted to explain further.

      AFLAC, and similar companies, aren't providing health insurance. Employers often bringing companies like AFLAC in to supply benefits funded solely by the employee should he/she decide to purchase. Employees can buy personal individual policies for products like individual Short Term Disability, Cancer policy, Critical Illness policy, and some individual Life Insurance products. Because these are personal individual policies it's the policy holder (the patient) who pays the premium, files the claim and submits the necessary documentation. AFLAC isn't paying any medical bills directly to a hospital / doctor, etc. AFLAC pays the policy holder a lump sum or regular weekly/monthly benefit payments. These are paid directly to the policy holder (In this case directly to magdem) . Cancer/Critical illness policies provide funds that can get used for medical bills, rent, car payments, etc (just like the AFLAC duck ads on TV state)

      over 8 years ago
    • pang's Avatar

      hello i had the same problem i told aflac and they can go on your behalf and you just need to write a letter for a itemized billing and attending doctor note for aflac to get and http://www.aflac.com/us/en/docs/policyholders/claimforms/S-00216.pdf sign and date this form and you are done and they pay... i dont know why people talk so badly about aflac but aflac have been the best company for people. you still pay these benefits like health insurance they help pay for your co payments, and pay you when your sick or short term disablity, or ur children it the hospital or accendent, when your a single mother with children and cant afford to take extra time off when children are hurt or sick aflac help pay for me to be with my children then working cus my work dont pay for my time off if my children is sick lately a lot of work stop famlia some like that ....

      about 7 years ago
    • Scubapelli's Avatar

      What about contacting your primary insurance and ask for a copy of the billing? Would that work?

      almost 7 years ago
    • Turtle21973's Avatar

      I am having the same issue but I have Allstate as my accident insurance . I work at the Veterans Healthare System. It is against federal law/ mandate to refuse to provide this form to a person asking. I simply taped to the patient advocate and I had the form emailed to me in 10 minutes! When told no by billing they'll them thank you I appreciate your help. ( they are only doing their job. Not their fault at all). Call the hospital administration or patient advocate and tell them the issue. Make sure to let them know the person you talked to and this is the key ". I understand they are doing their job and the were very polite and professional. ". But I have to have this form to file on my accident insurance that only I can file and they say they can not. Provide it to me. I am asking for a form that is required to get the money to pay you and I know you do have to provide me with that form so could you please assist me in obtaining it? 10 minutes a copy is emailed. To you. Problem solved! The key remain nice polite even toned and very positive! It works every time!

      over 4 years ago
    • em123's Avatar

      I realize this is an old thread, but I am having a similar problem - the hospital is refusing to provide me with the UB form despite numerous requests. Turtle21973, do you know the particular law/mandate that requires the provider to give you the form if requested?

      almost 4 years ago
    • Beahive44's Avatar

      This is an old thread but these problems still exist in 2019. The bad thing about Aflac is they advertise One Day Pay, which is great for a $25 doctor visit. But those are limited to one or two per year. The big ticket items require you to jump through numerous hoops to collect on. Aflac will purposely require very specific types of information and your dr/hospital folks will balk at sending it. What Aflac won’t tell you is that they won’t lift a finger to help you obtain this and it smacks of stonewalling. Aflac is great if you are okay with these type tactics. Not so great when you are seriously ill and don’t need more stress in your life.

      over 2 years ago

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