i think the hospital sent my insurance a wrong bill.
hello, i have ambetter peach state and my deductible is 5,700 and max out of pocket is 7,700. i had surgery on the 7th and northside had me pay 5,400 preadmission fees for the surgery cost (total thyriodectomy) and use of the facility since i had to stay overnight. i have the receipt and they told me the remaining fees would be sent later are seperate and they would be the surgeon, anasthesia as well as lab and medication fees. I ensured i was in network and made sure my doctors were too.
now there was a screw up day before my surgery northside called and said i was out of network and said i had to pay 40k, upon investigation and calling northside and my insurance back and forth i found out that northside put another member id on my file and claimed insurance was calling behalf of me. But the call refernce id showed it was for another member. Northside called me and apologized for the error and said that my insurance called and said i was in network and they verified the insurance called on behalf of another member and the supervisor has already put the notes on file that it was resolved and i didn’t need to pay anything further since i already paid for my surgery and i just have to wait for the other labs and medication fees as well as surgeon and anasthesia fees. A week after my surgery i called to request a itemized bill to be sent to insurance and they told me it was already sent to insurance.
i just looked at my claims in my member portal and saw northside send a whopping 50k to the insurance which shows in pending ( they still didnt process the medication i picked up from pharmacies and they didn’t process my preadmission payment so my deductible wasn’t updated either so i think that may take time) When i called the insurance to ask why there was a 50 k bill they said its under investigation and they cannot disclose further and i had to wait 30 days for it to resolve. is there anything i can do to know more about what happened or wait it out? im scared that this is another screw up. And i dont want to recieve sudden bills in the mail without it being resolved.