hubby insurance not paying/ not precertified by hospital

[dilar270]

We are from Kentucky. My husband was admitted into the hospital via emergency room. He woke up one morning and didn't know anyone or anything. The hospital admitted him under a behavior health code, and turned the claim into the wrong insurance company. By the time the turned it into the correct company, the 24 hr precertification had passed. Now I'm being stiffed with over a $5000 hospital bill. Am I responsible for this entire bill? Or is the hospital at fault. Please help.

 

[ALawyer]

Complain to the state insurance department and the insurance company again. You did make a good faith effort to notify them. If there was no prejudice to the insurance company, and little possibility that they would have done something different, they should pay it anyway and not try to weasel out. If the plan was provided by an employer complain to the employer too. And if you have a union, complain to them.

 

[dilar270]

In doing more research, I found out that the hospital did contact Anthem about this claim. Anthem authorized the admittance and gave a ref#. But since this was a mental health problem, Anthem failed to tell the hospital that they needed to contact Magellan (which is the correct company to contact) Therefore, Magellan denied the claim because of the 24 hr clause, and Anthem does not cover mental healt claims. Now what do I do. Please help.

 

[ALawyer]

See a lawyer.