Insurance company submitting 2 claims on 1 case

[stpthmdnss]

What is the name of your state?What is the name of your state? CA

We had a baby in December of 2003. My wife was released from the hospital after the requisite 2 days, but our daughter had to stay behind to clear up her high jaundice level. We received our $1000 copay bill within the next month. In August of 2004 we received another bill for $1000. After calling the insurance company we were told the file had been reviewed and the hospital was now treating it as 2 seperate admittances. One for my wife's delivery and one for the the babies extended stay. Is there a statue of limitations on how long a hospital has to change they're original claim and does that get passed on to us?

 

[purple2]

It is normal to have 2 separate claims, one for the mom and one for the baby. You are 2 separate patients. I doubt this has anything to do with the reason for nonpayment. What reason did the insurance company give you for denying the claim?

Did you file paperwork to add the baby to the claim within the deadline required by your policy?

 

[Beth3]

The baby is a separate person. Once born, the baby becomes a "patient" on his/her own and his/her billing is separate.

Sounds like your insurance plan has a $1,000 annual deductible/person or a $1,000 deductible per hospital admission. If the latter, your health plan may call for only for one "per admission" deductible being charged for mom AND baby if it's a routine delivery, which means both are discharged within 48 hours if not sooner. Presumably under the terms of your Plan, the baby's longer stay resulted in an additional per admission deductible being charged.

With no ability to review the particulars of your health insurance plan, I'm only guessing however.

 

[purple2]

Check the Explanation of Benefits form you received from your insurance company, which lists the reasons for denial of payment, and repost if you have any further questions. It's not possible to answer your question w/o this info.