We took our (then) one year old to the emergency room last December for RSV. We didn’t know he had it at the time he was just very sick so naturally that is what any parent would do. We aren’t the type that will just go to the ER. He was really sick : crying with nose clogged, coughing, having trouble sleeping etc.
We just got a bill now 8 months later for $500. We thought it was already taken care of since we always pay bills on time but upon talking to the provider they said it was because the insurance took a long time with the claim and ended up denying it saying they aren’t responsible. The provider couldn’t give me any reasons why and said we have to talk to the insurance.
My wife no longer has that insurance so I’m hoping that won’t be a problem. I feel like they might say they denied it because it wasn’t a real emergency. Well what do they expect? Wait until he stops breathing, plus what if he had covid?
If they say this then what can I do to try to get them to cover it? Do I have any options? Thank you in advance.
You need to contact the insurance and get an EOB to see why it was denied. Also only $500 shocks me for an ED visit are you sure the claim was denied and the balance wasn’t just applied to deductible or coinsurance?
Even if you don’t have that insurance anymore they can still help you and covered you while you had them. This is why it’s good to keep your old insurance cards for a few years so you have their contact information and your old ID
What does your EOB say?
A $500 bill from an ER visit is really cheap. It honestly sounds like your plan’s ER copay and maybe some coinsurance. There’s a difference between the claim being denied and the claim being processed with you paying your cost sharing.
Your policy covers claims while it was active, even if you no longer have insurance with that company. Call and ask why the claim was denied, and then what steps you need to take to appeal the decision. They will tell you what you can do to try to get them to cover the claim.
What did the insurance company say when you talked to them about it?
I guarantee this the ER copay which would be your responsibility. Did you pay any copay at the hospital?
> plus what if he had covid
What … what if he did? Are you actually worried about a 1 year old having covid? This is reddit, so I’ll get instantly downvoted, but my gosh, 1 year olds have virtually 0.01% risk of dying of covid if they get it. Unless this was a 1 year old cancer patient, which I pray it wasn’t, I just don’t get it.
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