Insurance denied my claim when obgyn referred me to the hospital

I’m pregnant. At my 30 week appt, I went for a routine visit and the doctor checked my cervix. I was dilated. She told me to go to triage for monitoring since it was my first pregnancy. At triage, the doctor decided to check me in for an overnight stay and give me 2 steroid shots 24 hrs apart so help with the baby’s lung development. I checked out the next day at 7 pm. I received a letter saying my claim was not approved because it did or meet MCG guidelines. Based on info submitted the health care services could be provided in a more efficient and appropriate setting. Decision was based upon medical necessity for acute inpatient care stay not being established. When they observed me in triage, I did not have regular contractions or cervix change or delivery of the baby.

What can I do to appeal this claim?

submitted by /u/Here4daT
[link] [comments]
I’m pregnant. At my 30 week appt, I went for a routine visit and the doctor checked my cervix. I was dilated. She told me to go to triage for monitoring since it was my first pregnancy. At triage, the doctor decided to check me in for an overnight stay and give me 2 steroid shots 24 hrs apart so help with the baby’s lung development. I checked out the next day at 7 pm. I received a letter saying my claim was not approved because it did or meet MCG guidelines. Based on info submitted the health care services could be provided in a more efficient and appropriate setting. Decision was based upon medical necessity for acute inpatient care stay not being established. When they observed me in triage, I did not have regular contractions or cervix change or delivery of the baby. What can I do to appeal this claim?
submitted by /u/Here4daT [link] [comments]Read Morer/HealthInsurance

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