Retroactive COBRA, penalty for no pre-authorization?

Hi,

I had emergency treatment that had me in the hospital for 3 days prior to new employer coverage kicking in but hadn't even received COBRA paperwork from the prior employer before the emergency occurred. About a week after I was out of the hospital I was able to get everything in order, premiums paid and retroactive coverage back to the 1st of the month.

Several months later all the claims were processed and none were denied, but they all have a 'penalty' of half the amount that they should of paid amounting to 10s of thousands of dollars with the EOBs stating "The ineligible amount reduces the plan benefits based on the penalty amount stated in the Pre-certification/Pre-authorization provisions outlined in your benefit plan".

This is a catch-22 situation, as it's impossible to get pre-authorization when I didn't have any insurance and when I got it it's required to be retroactive.

What is the best way to try and resolve this? I don't understand insurance law but can't fathom being penalized for not doing something that is impossible. Should I try to retain a lawyer to handle an appeal?

submitted by /u/Capable_Recipe6637
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