The title says the gist of it, we ran into a few snags with this over the past 3 years.
I first heard about this by getting collections calls in November of last year. Then I called collections, and they said it was for my hospital stay, so I resubmitted my insurance info. Then insurance denied it and said it was actually for the anesthesia bill (which was already paid for).
Fast forward to January of this year the collections/hospital called and told me it was actually for Elizabeth's (Not even my daughter's name) hospital stay. I corrected them you mean.... (My daughter's real name) and they said yes, so I gave them my insurance info AGAIN and they said "because it was getting submitted so late, they didn't think insurance would pay."
Fast forward today where we get a 4k bill in the mail marked Self-Pay.
Any advice on how to handle this? In most cases, we would just offer to pay but every step of this issue of the past couple of years has made it seem like someone royally screwed up on their end and they are trying to pass this steaming pile of crap onto us.
**UPDATE***************************************************************************
I spoke with our insurance provider, They basically said they saw a lot of issues with the claim.
The first guy said the filing was late and it didn't have an "Ineligible Reason Code" and he suggested to go physically to the billing department at the hospital with a witness, hand them my insurance info and have them refile it correctly.
He transferred me to a "Membership" helpline after that stating they might have more info and she found that it was first submitted this past February and found the below issue with the filing:
- My daughter wasn't added within 30 days of delivery (Not true I have her Temp card saved from a week after her birth)
- The doctor was out of network on her insurance (Also confusing because we use that same insurance to visit the same doctor to this day with no issues)
- The provider/doctor didn't file within 180 days (makes sense since we haven't heard anything until collections called
I explained how 1 wasn't possible because I have the temp card proving it and 2 didn't seem feasible because we got the all-clear before we even had our baby on top of we still use the insurance for that doctor.
She told me basically she couldn't do anything because the hospital is billing us directly and it's after the filing time. She said we basically have to prove they did not file it within 180 days of her birth.
I feel like it's going to be a lot of "We tried to call you and got no response" sort of deal. If anyone has any further advice we would appreciate it!
Submitted December 28, 2020 at 03:45PM by M0220H20 https://ift.tt/3aUSdQl
