What whos right?

Question:

Last week on Tuesday i was taken to my doctor for serious pains in my right side.He told me to go to the E.R.. I did they kept me over Tuesday night running tests, at first they found an infection but they ran more tests the next day on wedensday,i still wasn't released untill the next day.They found out that my gall bladder isn't working right and I will have to have surgery sometime later but anyways they kept me when i wanted to go home. So now my mom gets a letter from the insurance company saying they will not cover it because I wasn't kept in the hospital for any good enough reasons. My parents work hard but they do not have the money to pay for it. I was kept in the hospital by the doctors not by me or my parents for testing. So why shouldn't they cover it?I mean i could still have surgery any day because I'll need it sooner or later to remove my gall bladder.

Answers:
What you do then, is get the doctor that saw you in the hospital to write a letter of necessity to the insurance company. Obviously the doctors felt the need to keep you there and it would have been bad if they had treated you for what they originally thought was an infection when you really have gall bladder issues. They had a reason to keep you there. Get either the hospital doctor, or your doctor to write your insurance company a letter and explain this. The insurance companies have NO right to tell you folks that you weren't kept in the hospital for good enough a reason. That isn't a term of insurance. "Must have a darn good reason" They are being ridiculous and you and your parents have to fight them on that. Good Luck and Get Well Soon

P.S. Don't listen to Bob, she is wrong. They do have to pay.

I'm sorry but you're parents know what kind of coverageg they had- The doctors COULD have found something seriously wrong and if they had you would have had to pay more (but your insurance would have coverd it so not really)
Your definatly getting ripped off but insurance is right that they don't have to. It sucks and I'm sorry

You now understand why insurance companies own those big building down town. They will refuse your claims so you need to file an appeal. There is a process to appeal their denial. Follow through on the appeal you can make them pay.

Unfortunalty that is the way things are going these days. It is so bad that now insurance providers make the decisions concerning health care instread of doctors. I believe there is a special place in hell reserved for insurance providers!

Your parents can go through the appeal process. It's common knowledge that insurance claims agents are trained to first deny claims. Usually, though, the appeals process can take care of that.

call the hosp and tell them they need to recode the bill so it is paid by your insurance. i work in medical billing and we do this alot

DO NOT WORRY YOURSELF ABOUT THE COST OF THE PROCEDURE THAT IS YOUR PARENTS CONCERN.

What whos right?

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