I had my baby Jan 3, 2.5 weeks early. I looked on the insurance website just a minute ago and they have denied everything that had to do with my hospital stay. Why and how can they do that. I am freaking out because my bill is close to 11000 dollars. She was breeched and I do not tried to have her turned. I had a c-section. I can not believe that they can do this. I usually get a provider discount from the hospital and I got no discount either.
2007-01-18 10:29:54 · 7 answers · asked by trying4_baby 1 in Business & Finance ➔ Insurance
You need to call the insurance company and ask them why not. Some reasons could be: your insurance policy was cancelled, or maybe the hospital wasn't on the approved hospital list, or maybe someone at the billing office entered it wrong, or maybe someone at the insurance company was looking at the wrong paper.
Call the member services number on the back of your insurance card, and ask them for an explanation.
2007-01-18 12:21:38 · answer #1 · answered by Anonymous 7 · 0⤊ 0⤋
You will soon get in the mail a document called an "Explanation of Benefits" which will lay out what was paid, what wasn't paid and, most inportantly, why.
You will need that information to launch a formal appeal. Each state has a different set of rules on how insurers have to treat an appeal. You should learn your state's rules and begin the appeal process.
There is very little chance that your insurer planned to cover you and then didn't because of some kind of complications of birth. Either they were going to cover you no matter what.....or they didn't plan to cover you to begin with. You need to find out what the official reason for the denial is and fight it.
meantime, call the hospital immediately and tell them you are working on an appeal of the insurer's decision....that will buy you time to stave off a collection notice.
2007-01-18 16:10:45 · answer #2 · answered by markmywordz 5 · 0⤊ 0⤋
If the claim has been "finalized" - get the explanation of benefits (EOB) from the insurance that states EXACTLY why it was denied. Most denials are for something stupid, and you can fight it. DO NOT GIVE UP!!! The insurance isn't going to make it easy for you, they count on you getting annoyed with them. If it hasn't been finalized, wait until it is. Sometimes they show as denied, pending more information from the provider, but ultimately get paid.
If it was denied for something like no-authorization, enlist the help of your OB-GYN's office. They can help you appeal it. If was denied for "Coordination of Benefits" - contact your insurance company right away and ask what they need to prove you have no other insurance.
Just be dilligent about following thru on the appeal, don't let it slide by.
2007-01-19 02:28:45 · answer #3 · answered by zippythejessi 7 · 0⤊ 0⤋
You need to call your health insurance. I had a baby and had part of the claim denied because the provider did not submit correctly. Once they resubmitted insurance company approved and paid for it. I would not freak out yet, it is too early.
2007-01-18 13:52:20 · answer #4 · answered by mamatohaley+1 4 · 0⤊ 0⤋
It should have stated why your claim is being rejected or pended. Look on the website again and get more information.
2007-01-18 11:27:08 · answer #5 · answered by sawftandtender 4 · 0⤊ 0⤋
Was maternity coverage on your policy. Some policies do not cover maternity.
2007-01-18 14:53:55 · answer #6 · answered by darrenwelsh429 2 · 1⤊ 1⤋
You need to call them .
2007-01-18 10:38:05 · answer #7 · answered by Anonymous · 0⤊ 0⤋