possible unfair billing new jersey...please help

[bsgwolfpack]

Ok im hoping someone here can tell me what to do please. Heres the story I changed my health insurance plan on 6/1 to a new plan and had a follow up visit with a nose doctor for some post-op cleanup from surgery. The procedure wasnt urgent but i thought everything was fine, i walked in on 6/2 with my new card and said heres my new insurance and presented them with a new card they then proceeded to take me in for that visit and another follow up visit on 6/16. What i didnt notice at the time was that my new insurance card said it was an HMO plan when i had attended on purchasing a PPO plan. No one at their office caught it either or told me that i needed a referral. Then i get a bill for $1300 for services and then see the mistake when i look into it.

They tried to have me call my primary doctor and have them backdate a refferal for me but they were unable to do so. So now im stuck with a huge bill and i dont think its right. Granted i obviously made a mistake (bought in online apparently i clicked on the wrong packet and filled it out) but they are the professionals and i feel they should know better. The services done were a cleaning of the inside of my nose with some instrument it was not mandatory and could have been done after i straightened this problem out. So i do not want to have to pay this bill, my questions are as followed

1) legally, do i have any right not to pay this bill ?
2) does it matter that they did not ask for a referral either which also would have alerted us to the mistake ?
and
3) is there some medical association that i could appeal this bill to if i had too ?

youre help would be greatly appreciated thank you

[PMRNC]

Unfortunately this is your responsibility.. The insurance company fulfilled their obligations by policy..it was sort of up to you to know your plan, know that it was an HMO.  HOWEVER..the provider even though they really didn't do anything technically wrong, also missed this..what I would suggest is seeking their help with an appeal and they might even be able to do an out of network negotiation with the carrier.. MAYBE. Ultimately however the bill is technically your responsibility. There were no unfair billing practices. The liability ethically is split between yourself and the provider (ETHICALLY speaking, not legally speaking) If the appeal with the insurance company doesn't work out you might be able to negotiate a lower fee with the provider, by appealing to their sense of moral obligation for also failing to check before hand.

[bsgwolfpack]

thanks for the response, i will try to appeal and give it a shot. I do admit obviously it was moronic of me not to catch what i submitted it just sucks that people who handle this everyday arent held more responsible to make sure these mistakes dont happen. thanks again