ER visit after fall on stomach during third trimester EOB Denied – Next steps?

Hi all,

I’m trying to figure out what the next steps are to take here–a few weeks ago I had a fall where I landed on my stomach when I was in the third trimester of my pregnancy. I called my doctor and when I described that there was some spotting after monitoring kick counts I was directed to go to the ER by my OB. I was told by the ER doctor the standard practice for stomach falls with how far along I was in the pregnancy was a 24 hour surveillance period so I was there overnight and put into a labor room with the nurses monitoring both me for contractions and the baby’s heart beat. Everything is okay with the baby (thank goodness) but I received an EOB denial saying that the claim was denied as medically unnecessary. There was no real description behind the rationale, just that a doctor had decided it was not medically needed. The bill is for over $15,000 and with a new baby coming the thought of that is just pushing me over the edge.

Can anyone offer guidance on where to start? I haven’t gotten a bill from the hospital yet and I have 180 days to appeal the insurance denial but since I haven’t received a hospital bill I’m not sure what my next step should be. Any guidance would be very appreciated from people who have navigated this before.

Thank you!

See also  UMR prior auth