scrubbedexpat099

I have been asked toi help out sort out a somewhat late bill. I have asked for the coverage details but the situation would outside the US seem completely unbelievable.

Daughter covered under Fathers plan. IBM plan, so should be better than most.

Pregnant, gives birth, claim filed under Fathers plan.

Nearly 4 years later, Hospital sends bill for Nursery (2 nights), Medical/Surgery and Audiology.

Total, just over $1,300.

The funny thing is that this is not for her, but the newborn, it seems to be that as soon as the head is out, then it becomes a seperate individual and coverage issue. So the Daughter's costs are covered but not the Grandaughters.

Worthy of a comedy sketch, hold the contractions, we are still shopping for coverage!. And how could you cover a not yet born baby when you know there will be costs as soon as it pops?. Pre-existing condition!

Anyway, whilst I am waiting for the docs to come through, just wondered if anybody had come across this?

And is there a time issue with enforcement of a bill such as this.

She earns bugger all less 10, so its not as if she has the funds to write a cheque.

Manc

I do believe any newborn has an automatic 30 day extension of coverage from any coverage the mother is receiving.

Elvira

Would this help:

"Under the Newborns' and Mothers' Health Protection Act, if a plan covers maternity or newborn benefits, it must allow mothers and newborns a 48-hour hospital stay after a vaginal birth and 96 hours if a cesarean section has been performed..."

http://www.ehow.com/how_6288_cover-pregnancy-with.html

(I googled for "pregnancy newborn insurance coverage" - there may be other useful information there!)

scrubbedexpat099

Thanks,

I have left a message with the Hospital asking for details of why the claim was turned down, I seem to remember that it was an easy birth, so I am assuming that the grandaughter was in for just 2 days, rather than this being for days 3 and 4.

I can see this being fun!.

Celsius

Is there a time limit as to when billing can occur? Billing you four years after the event seems rather tardy...

Might be a federal or state law that allows insurance companies x no. of days to bill patients.

fatbrit

Get this big stick to clout them with as well: http://www.dora.state.co.us/insurance/index.htm

fatbrit

Best to go to writing at this stage. Fax is suitable. Open a file...

scrubbedexpat099

If I can get the to drop it quicky and quietly, fair enough.

If not I will cover all bases. My background is Insurance. I think this is Hospital cock up, but we will see.

Elvira

In my experience, phoning is more likely to produce results - I have found that letters and faxes tend to get ignored. But one has to insist on talking to a supervisor. Get that person's name AND direct line # (if willing to reveal).

And definitely start a file and document everything!

fatbrit

Problem is when they seem to have dropped it and then you have the collection agency calling and the credit blotch recorded. Hospital billing depts are pretty well the lowest of the low on the morality scale. Trust them not one iota!

scrubbedexpat099

Well they have an old bill they want settling and she has no credit rating worth harming, so I think we have more cards.

Just treating it as any other business issue.

fatbrit

Did one recently for someone whose only blotch was a med collection and they wanted it off to apply for a prime loan. Negotiated on phone, then insisted I would fax them the written agreement we had come to and they would sign it and fax it back. They certainly didn't like this idea...but they acquiesced eventually.

scrubbedexpat099

Thanks.

Noted.

scrubbedexpat099

You negotiated part payment?

Bob

For our medical...kid has to be enrolled in advance to get covered...but the problem is, unless the kid is born, the enrolment is void...and can only enrol between Nov 1st and Dec 29....but I think it would be covered for 48 hours from birth...but your buggered if the kid is born sick...