I had an inpatient laparoscopic nissen fundoplication January 5th, with one day hospital stay. Prior to the decision to have surgery, I had motility studies done and an endoscopic exam. The motility study showed that I had low pressure, the endoscopic exam showed that I had esphagitis. Anyway, the doctor that did the motility study and the surgeon decided that I should get a lap nissen fundop. After I met with the surgeon he set up the time. Well, anyway, I got this letter from my insurance company stating that the hospital never obtained prior authorization before the surgery per their contract, and that I may not be responsible for the bill. They denied the insurance claim and said that the hospital can appeal. However, they wouldn't have paid it anyway, because the surgery could have been performed as an outpatient surgery. (They did however pay for the surgery itself, they just refused to pay the hospital stay) Do I owe the $16,000 + hospital bill?
2007-03-28
19:37:00
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5 answers
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asked by
Jay S
5
in
Insurance