am I required to pay final emergency surgery bill when hospital did not provide authorization for surgery to health care providor?
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am I required to pay final emergency surgery bill when hospital did not provide authorization for surgery to health care providor?
Went to a emergency room with pain. found out I had appendicitis, which required surgery and moved to their main hospital. United Health Care did not pay out considering they did not receive ‘authorization notification for surgery’ and now hospital is sending me the bill for 26,731.00.
Asked on August 31, 2018 under Business Law, Alabama
Answers:
M.T.G., Member, New York Bar / FreeAdvice Contributing Attorney
Answered 5 years ago | Contributor
Generally speaking, an emergency surgery is just that: an emergency. Pre-authorization may not always be possible but the hospital had the obligation to bill it properly. You need to start a campaign against both your insurer and the hospital. First, you need to find out how the procedure was billed by the hospital to the insurance company. Next, you need to write a letter (file a complaint) against the insurer with your state Department of Insurance. Ask for help in investigating. Start there and see how that goes. If the hospital incorrectly billed the procedure or did not file in time then you need to prove that. And if the insurer had notice but refused to pay for some technicality then you need to know that too. Good luck.
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