Reagarding Baby's Coverage for the first Month

[sarithamurthy]

What is the name of your state (only U.S. law)? VA

I gave birth to baby boy on 20 th June 2008.

I got his insurance under me from August 1 st of 2008.

But I am getting bills on his name for the service in the initial days of hospital say (20th june 2008 to 23 jun 2008)

for these bills Insurance claims has rejected saying that he is not having insurance on those days so no claims will be processed and hence resubmit the bill in name of mother?

I requested the same to providers (hospital) but again they are saying they couldn't bill on my name as my baby is not covered in my name for those days?

what is actual procedure for this? what should I do?

Please respond,some one could have faced this problem,

Thanks
Saritha

 

[ecmst12]

You needed to add the baby to your insurance policy within 30 days of his birth. Since you did not do that, he has no coverage from birth through 8/1. You will have to pay his bills out of your pocket.

 

[sarithamurthy]

The bills which I got from provider (Hospital) is for the services rendered on his day of Birth that is 20 th June 2008.

I added him into my coverage on 1st Aug 2008.

Even If I added my baby within 30 days,If the hospital send the bill for the same service dates 20th June 2008 to 23 June 2008

Still do I need to pay from my pocket as my baby is not covered for those days?

Please respond

 

[Zigner]

The bills which I got from provider (Hospital) is for the services rendered on his day of Birth that is 20 th June 2008.

I added him into my coverage on 1st Aug 2008.

Even If I added my baby within 30 days,If the hospital send the bill for the same service dates 20th June 2008 to 23 June 2008

Still do I need to pay from my pocket as my baby is not covered for those days?

Please respond

Thanks for the additional info. Based on the new information:

You needed to add the baby to your insurance policy within 30 days of his birth. Since you did not do that, he has no coverage from birth through 8/1. You will have to pay his bills out of your pocket.

 

[ecmst12]

If you had added him within the 30 days, the coverage would have been retroactive to his date of birth. Because you did not, the coverage starts on the date he was added.

 

[lkc15507]

It appears that your newborn was inpatient longer than the 48 hours allowed as a newborn. If that is indeed the case, your newborn needed to be enrolled in a healthplan for coverage. That requirement begins when it is determined that the newborn requires inpatient hospitalization going beyond the scope of the 48 hours allowed for a well born, new born child and is admittited to the facility as such. As I posted to a similar post / situation, if out-of-pocket charges specific to the baby are incurred in that gray window of 48 hours, they can be appealed to the payer.