Hi Everyone,
I’m having a problem with claims (chest Xrays) my dad got at a hospital he had to stay in because of the Texas blackouts. The insurance company says that I should get a retroactive referral from his PCP so that the claim can get approved. I told his PCP and they said that they are unable to do retroactive authorizations and to contact the facility who rendered care. Bounced back to the insurance company and they told me that the PCP should be able to and if they can’t maybe I should look for a new PCP. I really like his PCP so I’d like to find a work around.
Additionally, the hospital is showing on his online portal as out of network. This is odd in that I begged to get him transferred out of there because he felt he wasn’t being taken care of. The hospital told me repeatedly that nothing could be done as it was in network and he did not need a higher level of care than the hospital could provide. Double checked with my insurance provider and they said that the way the hospital filed the claim it shows them as out of network.
Any advice? Sorry if I missed any pertinent information
TIA
submitted by /u/Nnlpzj
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Hi Everyone, I’m having a problem with claims (chest Xrays) my dad got at a hospital he had to stay in because of the Texas blackouts. The insurance company says that I should get a retroactive referral from his PCP so that the claim can get approved. I told his PCP and they said that they are unable to do retroactive authorizations and to contact the facility who rendered care. Bounced back to the insurance company and they told me that the PCP should be able to and if they can’t maybe I should look for a new PCP. I really like his PCP so I’d like to find a work around. Additionally, the hospital is showing on his online portal as out of network. This is odd in that I begged to get him transferred out of there because he felt he wasn’t being taken care of. The hospital told me repeatedly that nothing could be done as it was in network and he did not need a higher level of care than the hospital could provide. Double checked with my insurance provider and they said that the way the hospital filed the claim it shows them as out of network. Any advice? Sorry if I missed any pertinent information TIA
submitted by /u/Nnlpzj [link] [comments]Read Morer/HealthInsurance