Will the amount become my responsibility if the claim is denied because of prior authorization? Insurance: UMR, Provider: M Health Fairview
Hello, everyone
I added my baby boy to my UMR Insurance as soon as he was born. This was back in June 2023
My newborn baby became sick as soon as we reached home after my wife’s delivery so we had to take him to M Health Fairview Riverside Emergency Room and this provider is in-network for my UMR Health Insurance.
The doctors ran tests and told he needs to be admitted in the hospital for care as he was unable to feed and he has some infection due to labor stress or something.
We stayed in the hospital for 2 days and my baby became better and they discharged us. The bill came in and it was $27000.
The claim was denied because there was no prior authorization from the insurance. The provider has been trying to appeal for almost 5 months now and I have no update yet.
Now I am worried what do I need to do. Will this $27k become my responsibility? As mentioned the provider is in-network and they are appealing to my insurance.
Can y’all please help me out and let me know what to do? I can’t afford this huge bill.
Appreciate your help and thanks in advance!
submitted by /u/risingstar_78
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