(US post btw) I had a baby recently and had to get a c-section. Through my employer’s insurance I had to go to a specific hospital group to get maximum savings. I checked multiple times from the insurance to make sure the hospital and ob gyn, nurses, anesthesiologist fell under this maximum savings umbrella.
Gave birth, everything goes well and got the expected bill, no issues there. 3 months later, I get a message from my insurance saying there is a new claim of around $9300 that has been denied. Apparently the assistant surgeon (not my normal doctor) was not under this maximum savings umbrella. In fact, the doctor isn’t even covered by my insurance at all, so this charge must come out of pocket.
I made an appeal immediately and they recently denied my appeal because the doctor wasn’t covered. I tried explaining how these asst surgeons have a rotating schedule so I had no idea/control which asst doctor I would get.
I’m at a standstill and don’t know what to do. I can make one more appeal, but what else should explain? Should I call the asst doctor to try to lower this amount? Please help! This is a very unexpected amount and any advice on trying to lower it would be great.
Submitted August 29, 2020 at 11:19PM by suenoselectronicos https://ift.tt/3hKfvce
