Im covered in NJ. I fractured my hip in PA and needed to have emergency surgery.
The surgery was done at an out-of-network facility.
My insurance is putting my coverage in Tier 2, which forces me to pay co-insurance.
My contention is since this was an emergency, I should be billed at Tier 1.
I believe NJ has banned billing practices like this. PA has banned balance billing.
Insurance is saying I can file an appeal. Is there another option or is this the best route?
submitted by /u/mlutz153
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Im covered in NJ. I fractured my hip in PA and needed to have emergency surgery. The surgery was done at an out-of-network facility. My insurance is putting my coverage in Tier 2, which forces me to pay co-insurance. My contention is since this was an emergency, I should be billed at Tier 1. I believe NJ has banned billing practices like this. PA has banned balance billing. Insurance is saying I can file an appeal. Is there another option or is this the best route?
submitted by /u/mlutz153 [link] [comments]Read Morer/HealthInsurance