Q: Medical insur claim: She we be worried and take some kind of action? Or just wait and see what happens?
My wife had thyroid surgery Aug 2022. The surgery was pre-authorized by insur for overnight, 23 hours. The hospital dragged their feet releasing my wife so the 23 hours was exceeded. Insur co denied the claim for exceeding 23 hours. We’ve never rec’d any correspondence from the hospital and they seem to be doing nothing to get their claim paid. The claim amount is over $92,000 (excessive from what I have read for this type of surgery). The insur company says we owe nothing and their claim denial shows nothing owed by us.
A: A Nevada attorney could advise best, but your question remains open for two weeks. Based on the brief description, one can only make some general guesses. One might be that the insurance company took a more lenient stance on the twenty-three-hour issue. Another is that they might choose to take matters up with the hospital. These are only a couple of general guesses. A Nevada attorney who deals with health care claims could advise more definitively after reviewing the entire file. I've only outlined a few generalities. One option might be to send the insurance carrier a letter asking them to confirm that there is nothing owed by you, which already seems to be the case, based on their denial. Good luck
A: Addendum - as an addendum to my response from a minute ago, it could also be advisable to review the file, or have an attorney review the file, from the hospital end of billing, just to have all your bases covered. My guess would be that they would have billed by now, but that way you could be more confident in reducing the chances for surprise bills. Good luck
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