Ok so this might be confusing, any advice would be amazing. So on November 19th we found out my husband’s (43 years old, $19.00/hour income) appendix ruptured and that resulted in an ER visit, an emergency surgery, air transport, and 2 weeks in the surgical ICU at Vanderbilt in Nashville, TN. They think his appendix actually ruptured 6 days prior to the ER visit so he was in full septic shock when admitted. At the time he was uninsured as he had just started a new job and insurance didn’t kick in until Dec 1. While in the SICU he was intubated and sedated and I had to make his medical decisions. We thought this would be all uninsured until the new insurance kicked in. Well, as I was navigating things, I realized he was still under his COBRA eligibility. So I signed him up for coverage under COBRA retroactively to Oct 1st, which means he was insured on Nov 19.
Well now Anthem is trying to deny the SICU stay as they are saying there was no preauthorization. As of right now, according to the EoB on the app, they’re denying the $330,000 claim for the SICU stay. Where do I begin to fight this? Do I wait for the bill to come? Does the billing department at Vandy fight it? This is all new territory for me and I’m not sure where to begin.
submitted by /u/prissypants9505
[link] [comments]Ok so this might be confusing, any advice would be amazing. So on November 19th we found out my husband’s (43 years old, $19.00/hour income) appendix ruptured and that resulted in an ER visit, an emergency surgery, air transport, and 2 weeks in the surgical ICU at Vanderbilt in Nashville, TN. They think his appendix actually ruptured 6 days prior to the ER visit so he was in full septic shock when admitted. At the time he was uninsured as he had just started a new job and insurance didn’t kick in until Dec 1. While in the SICU he was intubated and sedated and I had to make his medical decisions. We thought this would be all uninsured until the new insurance kicked in. Well, as I was navigating things, I realized he was still under his COBRA eligibility. So I signed him up for coverage under COBRA retroactively to Oct 1st, which means he was insured on Nov 19. Well now Anthem is trying to deny the SICU stay as they are saying there was no preauthorization. As of right now, according to the EoB on the app, they’re denying the $330,000 claim for the SICU stay. Where do I begin to fight this? Do I wait for the bill to come? Does the billing department at Vandy fight it? This is all new territory for me and I’m not sure where to begin. submitted by /u/prissypants9505 [link] [comments]Read Morer/HealthInsurance