So my wife and I had a baby 3/6/2014, due date was 2/26/2014. Insurance with BCBS through employer started on 3/1/2014. I started with employer in January 2014 and got all the paperwork ahead of time for insurance and read through all of it.
I got my bill from the hospital and there was a $1,000 Penalty for not calling 2 business days after being admitted into the hospital. I am pissed. How can this really be legal?
1. Is it really reasonable to expect someone to remember after no sleep in the hospital and barely awake that they have to call the insurance company 2 business days after get 'pre-certified'? How would someone remember that they read this little stipulation months before? It sounds like a way to get peoples money.
2. "BCBS has established the MSA(Medical Services Advisory) for the specific purpose of assisting you in determining the course of treatment which will maximize your benefits provided under this Certificate. Should you fail to notify the MSA as required by the PreAdmission Review provision of this section you will then be responsible for the first $1,000 of the Hospital or facility charges... blah blah blah...". "Our records do not indicate a call was made to pre-certify the hospital stay..."
So i would like to know whats the purpose of getting certified by calling them so that they can 'determine the course of treatment' when we have already gone home from hospital??? What is the purpose of 'performing a review' of services including Maternity when they already cover maternity services and I have already been admitted, had the baby, stayed at the hospital and gone home??? Why would they need to pre-certify the hospital stay if Ive already gone home???
It sounds like they are fining me for simply not letting them "review" something that they already cover???
Can someone give me any advice as to what to do? Or if anyone has been through this type on nonsense??
I got my bill from the hospital and there was a $1,000 Penalty for not calling 2 business days after being admitted into the hospital. I am pissed. How can this really be legal?
1. Is it really reasonable to expect someone to remember after no sleep in the hospital and barely awake that they have to call the insurance company 2 business days after get 'pre-certified'? How would someone remember that they read this little stipulation months before? It sounds like a way to get peoples money.
2. "BCBS has established the MSA(Medical Services Advisory) for the specific purpose of assisting you in determining the course of treatment which will maximize your benefits provided under this Certificate. Should you fail to notify the MSA as required by the PreAdmission Review provision of this section you will then be responsible for the first $1,000 of the Hospital or facility charges... blah blah blah...". "Our records do not indicate a call was made to pre-certify the hospital stay..."
So i would like to know whats the purpose of getting certified by calling them so that they can 'determine the course of treatment' when we have already gone home from hospital??? What is the purpose of 'performing a review' of services including Maternity when they already cover maternity services and I have already been admitted, had the baby, stayed at the hospital and gone home??? Why would they need to pre-certify the hospital stay if Ive already gone home???
It sounds like they are fining me for simply not letting them "review" something that they already cover???
Can someone give me any advice as to what to do? Or if anyone has been through this type on nonsense??