Hospital Reports Procedure Incorrectly to Insurance Posted: 10-27-07 13:23pm
So here is the sequence of event:
My Girlfriend needs procedure A done
Doctor approves and faxs to insurance
company request for pre-approval for
procedure A
Insurance company says pre approval not
needed
Doctor sends paperwork to hospital for
procedure A to be performed.
Procedure A is performed BUT forms to
health insurance report procedure B was
performed (forms marked incorrectly)
Insurance company say that B requires
pre-approval which wasnt granted (since it
was A that was asked about AND performed)
Insurance sticks girlfriend with bill.
The question is what can be done to fix
this? At the hospital a form was signed
saying that if health insurance doesnt pay
for the procedure, the patient wll. But
it was obviously a mistake on the part of
the hospital, marking the form that was
sent to the health insurance incorrectly.
This is still being processed. Any
Ideas?!!!
Thanks
Sandy
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yogahoneybunny
Supporter
Joined: 04 Jan 2006 Posts: 871 Location: Strumica, Macedonia
Thanks: 2
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Posted: 10-29-07 07:47am
Was procedure B actually performed?
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jeru
New User, Becoming EHEALTHy
Joined: 27 Oct 2007 Posts: 2
Posted: 10-29-07 09:03am
No, A was performed but B was reported to
the insurance company as the procedure
that was performed by mistake.
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yogahoneybunny
Supporter
Joined: 04 Jan 2006 Posts: 871 Location: Strumica, Macedonia
Thanks: 2
Thanked:0
Posted: 10-31-07 06:20am
HOSPITAL FAULT! There's no legal grounds
for insurance company to pursue a charge
for a procedure that wasn't performed.
Call hospital administration ...
immediately!
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