Claim Denials
Hi, I’m looking for some opinions on my recent claim denials. My wife gave birth last October and the hospital took both my insurance and wife’s (they’re different), my wife’s insurance was for her and my insurance was for my newborn.
Everything should’ve been covered per usual benefits and we went on with our lives. Later we start to get denials from my wife’s insurance, regarding our newborn’s care, because he wasn’t added to the policy. That’s normal and expected, we never added him to her insurance, only mine. After multiple phone calls and inaction from the billing department, I emailed recently detailing the situation and that they must stop filling claims with the incorrect insurance.
I should mention that the hospital did file claims to my insurance for my newborn correctly for some services during our stay at the hospital and they got paid out, as expected. But they just weren’t submitting most of the other services to the correct insurance.
Fast forward to them getting my email and acting on my request, I’m seeing claims get denied now, citing code *00312. “This service was submitted for payment after the claim filing limit. The member is not responsible for this amount.”
Am I in the clear here? Or should I expect to lawyer up? Thanks for any insight.
submitted by /u/Plzcuturshit
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