Hospital Insurance Mix-Up Advice Needed

Hello. Last fall, I was referred to an out-of-state neurosurgeon for an evaluation. Since it was out-of-state, I asked the referring physician to submit a prior authorization request since I am an Iowa medicaid patient, and I figured it would be out-of-network. The hospital provided billing codes to my physician for the appointment, which were then provided to my insurance company. Based on these billing codes, we were told I didn't need prior authorization.

After being diagnosed and offered surgery, I was told my insurance could not be accepted, and I would not be able to be treated there.

Here's several other pieces of information that may or may not be relevant: 1. I would not have pursued diagnoses or treatment at this hospital if I had known my insurance would not be accepted. 2. According to my insurance company, no prior authorization for surgery was ever submitted. The billing department at the hospital told me it was submitted and denied, but was unable to provide a claim number or any way to reference this to my insurance company. 3. They have accepted and treated other out-of-state medicaid patients 4. It cost ~$4000 to travel out there twice and having to stay an extra week due to the doctor getting COVID 5. My conditioned has worsened during this 8-10 month period and is likely permanent damage to my spinal cord

I guess my question is – do I have any legal standing to recoup damages for my travel costs or that my condition has worsened during this time frame? I've filed a complaint with the hospital Patient Services department – is there anywhere else I can reach out to for assistance?

Thanks

submitted by /u/Baenre240
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