letter from insurance

[Andersson]

We just received a letter from our insurance company stating that the last time my wife was in the hospital was "deemed medically necessary". Is this something new companies are doing? We have never gotten one before but we are still waiting for the bill so I wont count my chickens until they are hatched.

 

[Regis]

I'm guessing a lot of idiots try to get their insurance to play for plastic surgery. As long as it says deemed medically necessary I wouldn't worry about.

 

[Bear]

That "should" just mean that your medical insurance will pay for their portion of the hospital stay because it was in fact medically necessary. Unfortunately, your portion of the bill may still be daunting.

 

[polamalu43]

Ha! Did you have to call to get prior approval prior to the hospital stay? I bet the bill will be a whopper. Seems we pay higher premiums for less coverage and higher out of pocket payments these days.

 

[Andersson]

I am waiting to see if daunting actually plays out or not. We even received two of these letters but oddly enough they are counting a four day stay when it was only two full days. I would guess maybe 47 hours total stay time (admitted and all).

 

[themdno]

If it's fully covered by the insurance, there is a good chance the hospital just double the length of stay, so they get twice the money. If it's not fully covered, I would make sure that the hospital isn't doing this, because that's pretty evil.

It may just be a clerical error, but I'm always the guy that thinks it was on purpose. Haha...

 

[Andersson]

I love how hospitals operate, that is when they want to. We are still waiting for these bills to be cleared up and have been advised to not pay anything until the final bill comes in. It has been over a month and it makes me wonder if they are too busy or what.

 

[Regis]

They could still be waiting to hear from your insurance. This can take a while especially if you have both a primary and secondary insurance. I'm just now getting the bill for a doctor's visit in February.

 

[Andersson]

It gets better! Yesterday I opened the evening mail to see a $6000.00 bill, after insurance covered the rest. I have been on the phone with insurance off and on through the day and awaiting a call back. I think someone needs fired in the math dept. For such a short stay and having a 20% pay (after insurance) there is no way that bill should be that high.

 

[Michael]

I am glad insurance companies are paying attention to what they will pay for. I never understand some cosmetic surgery. I also think things like Viagra should be paid for by the patient and not the insurance companies, although I realize there will be people who disagree.

 

[JCJ]

I got a letter that said the exact same thing when I was hospitalized back in December. The bill was $6,000?? I was in the hospital for seven days, had a minor operation to fix a skin thing, and still didn't have to pay that much. The total bill that was sent to the insurance company was $21,000, but the insurance company's "network discounted rate" knocked that down to $4,000, of which I had to pay around $1,200. If they can afford to provide a discounted rate of $4,000 why are they billing $21K in the first place? I'd hate to imagine if I had NO insurance and had to pay cash. Would they discount it then? Probably not.