The double statements are the tell-tale sign. The hospital bills as a result of the patient responsibility amount in the insurer's remittance advice. If that indicated two deductibles, the patient should contact the insurer, as hospital won't question plan provisions and terms.
Hospital Stay December 31 - January 1
- Thread starter danda
- Start date
How about someone read the original post? It IS a carryover issue. The hospital didn't bill twice, its 2 separate bills. The anesthesiologist administered/billed the epidural on 12/31/14. Hospital release/bill date was in 2015. They aren't getting hit with 2 deductibles for the same bill, its two different bills.
OP...call your carrier and beg. Hopefully, you can get it changed to only one deductible. If they tell you no, ask for the appeals process and appeal. Remember that customer service reps are paid to read from the screen in front of them. For this issue, you need someone who is allowed to think. (It may not work, but its worth the effort)
And congrats on the new baby!
OP...call your carrier and beg. Hopefully, you can get it changed to only one deductible. If they tell you no, ask for the appeals process and appeal. Remember that customer service reps are paid to read from the screen in front of them. For this issue, you need someone who is allowed to think. (It may not work, but its worth the effort)
And congrats on the new baby!
Beg to differ, but some services were administered and incurred in 2014. The date of service dictates when and how the charge is adjudicated by the carrier. A global bill by the hospital MAY override the dates of service but don't count on it.
Even if the hospital issues a global bill the charges by the anesthesiologist may be billed separately if they are a contract employee vs. staff employee.
Even if the hospital issues a global bill the charges by the anesthesiologist may be billed separately if they are a contract employee vs. staff employee.
We aren't disagreeing. We are just saying it differently. Same hospital stay. 2 bills. 2 providers. 2 years.
Technically, there are 2 deductibles and there should be (no carryover) from the same stay.
My point is to call the carrier and beg. It may not work, but its worth a call.
Which is exactly what I said. Hospital pays based on insurer and won't argue with them on policy language issues.
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