NICU-Neonatologists Billed Out of Network

Hi!

I need some advice. I had my son 5 weeks early. He was admitted in to the NICU for two weeks. The hospital I delivered at is in network.

We are having issues with the insurance. We hit out out-of-pocket maximum as confirmed by the insurance company (UMR/United). However, they are now billing the neonatologists out of network, so we'd have to pay above the out of pocket limit. What makes it more confusing is that they billed some of the neonatologists visits as in network, and some as out of network. I have a benefits concierge that is supposed to "advocate" for us, but he is claiming that if I appeal they may reverse the in-network charges and make everything out-of-network.

Has anyone successfully appealed their insurance with a similar situation? I am just so confused with all of this back and forth. I am still working but am thinking of resigning to stay home with the kids. Should I wait until the insurance issues are resolved? I feel like it could take months to get everything figured out.

submitted by /u/aliwali_001
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