Insurance Denied Coverage for Inpatient Hospital Stay

I’m currently stuck as the middle man between my insurance, the hospital, and 5 doctors who haven’t been paid yet.

I was admitted to the hospital on July 26th for what my primary believed was a spinal fluid leak. I stayed until August 2nd. Saw a infectious disease doctor, neurologist, spinal tap, two MRIs and two CAT scans. Got out. Doing better. Nbd.

The hospital issued the prior authorization as being for a migraine. My insurance only covers three days in the hospital for migraines so they denied for not being medically necessary. I’m now getting bills for doctors asking to be paid. For some reason my room and board, MRIs, etc were all covered but not the doctors.

Called my insurance and the person on the phone thought the entire situation was strange. We’ll call her Shelby. She kicked it back to the claims group. I’ve met my deductible so she thought I should be covered for an inpatient stay. Shelby called me saying that the reason my claim was denied is due to the provider not sending any documentation or clinical notes to justify my stay. Shelby gave me a number for my provider to call.

Called the hospital provider billing department. They said I need to contact each of my providers. So I called the number on each of the bills I received. The doctors offices all say the insurance is supposed to request it and the hospital should provide it.

So I’m stuck as the middle man with $2000 of bills with everyone pointing the finger at each other.

submitted by /u/AtomicDeadlock
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