Been running around with the hospital and insurance for over a year and do not know what to do.

Last year I had a series of rabies shots at the ED– as that is the only place that has the vaccine in stock. The insurance covered 3/4 of the series and visits but there was one that did not get covered and I had an EOB that showed the denial and that my responsibility was $4000.

I had not yet gotten a bill, but I called the hospital and asked them to recode to be like the other visits because clearly there was an error here as I had gotten essentially identical visits the other times (I actually did get an itemized statement during this process and literally all that is on there is the visit and the shot).

So I keep calling them back to recode this and they keep resubmitting to my insurance it keeps getting denied. I tell them to reference the other visits that were covered. Every recode is taking like 6 months to process and get a response back from my insurance. I call my insurance and ask where the coding is going wrong and why the other visits were covered but not this one.

Last time I called was in August, and they said they were waiting to hear back from my insurance. Calling the insurance they said they never got the recode and then called the hospital back who assured me they have sent it. The insurance company says I cannot file an appeal on their end while the hospital still has it in their adjustment department.

I have still never been sent an actual bill from this visit. I check my credit religiously. I don't know what to do at this point. I don't even know what to ask for. I keep getting different codes listed by the insurance as the problem, I keep getting variable representatives from the hospital, and I really cannot pinpoint why this isn't getting covered.

Given the time elapsed since the visit, I don't even know if I am able to appeal this or keep submitting for recoding, though the insurance told me last time there is an extension right now because of COVID a few years ago but I don't know actually because I keep getting all of these different answers.

Do you guys have any advice on what I can do? My fear is that, even though I have never gotten a bill, the hospital will put me in collections and my credit will be tanked. Obviously, I would also like my insurance to pay their portion, but I don't know if that is even possible at this point.

submitted by /u/R0ckLobstaaa
[comments]