Medical billing issue - Update in replies

[karinothing]

We just got a 450 bill from when I had to take the baby to the ER. it says insurance paid zero. I know this is wrong since we have been to ER before and only have a 125 copay.

So do I call hospital or insurance first? I am annoyed because the insurance website is down the first time I ever really needed to look at stuff.

[kaycee]

I had this happen with something related to my birth. I called the hospital and they resubmitted the claim to insurance for me.

[Deleted]

I'd call the collector and verify they submitted the claim with the right numbers.

[karinothing]

Ugh I got the insurance website to work it says they denied the claim but doesn't tell me why. They paid the hospital but not the doctor.

Even if she was non preferred the benefits book says that doesn't matter for ER visits. So annoying.

[steamboat185]

The doctor might have been out of network. If you talk to someone with your insurance company they will probably fix it for you. Most states have laws that require insurance companies to cover ER visits as in network.

[katiescarlett]

Dec 14, 2015 19:07:51 GMT -5 karinothing said:

Ugh I got the insurance website to work it says they denied the claim but doesn't tell me why. They paid the hospital but not the doctor.

Even if she was non preferred the benefits book says that doesn't matter for ER visits. So annoying.

We got a bill for almost $500 after our first ever visit. Apparently the hospital was contracted with our insurance but not the ER physicians. This still makes me ragey 2 years later.

[karinothing]

Dec 14, 2015 19:58:10 GMT -5 steamboat185 said:

The doctor might have been out of network. If you talk to someone with your insurance company they will probably fix it for you. Most states have laws that require insurance companies to cover ER visits as in network.

Yeah the benefits book says ER docs ate covered even if not preferred so I am guessing some odd mistake.

[miamigirl]

I'd contact your insurance.

It happened to me once, I went to the ER and while the hospital was in network, the doctor was not...

[karinothing]

Dec 14, 2015 19:58:22 GMT -5 katiescarlett said:

Dec 14, 2015 19:07:51 GMT -5 karinothing said:

Ugh I got the insurance website to work it says they denied the claim but doesn't tell me why. They paid the hospital but not the doctor.

Even if she was non preferred the benefits book says that doesn't matter for ER visits. So annoying.

We got a bill for almost $500 after our first ever visit. Apparently the hospital was contracted with our insurance but not the ER physicians. This still makes me ragey 2 years later.

Ugh. We have been before no issue. In fact, husband went 2 months prior and we had no issue. Hope we can get it fixed

[karinothing]

So I. looked at the EOB and it says -

893--THE PROVIDER INDICATED ABOVE SUBMITTED THIS CLAIM AS PART OF A PARTICIPATING
PROVIDER GROUP PRACTICE. HOWEVER, AT THE TIME OF SERVICE, THIS PROVIDER WAS
NOT YET CREDENTIALED WITH THE GROUP PRACTICE. THEREFORE THIS CLAIM IS BEING
DENIED AND YOU ARE NOT RESPONSIBLE FOR THE CHARGES.


So I called the insurance and the lady on the phone called the hospital and got them to re submit the claim with the proper code so hopefully it will be taken care of. I told her she made my Christmas and she sounded very happy lol. Hopefully this takes care of it.