Hospitalized 2 or More Times in 2 Years

Sep 30, 2015

  1. Justin Bilyj
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    Justin Bilyj Guru

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    Got a decline today due to being hospitalized two or more times in a year. The client was fuzzy on one of the operation times, but only one was over night the other two were out patient. I thought the question was referencing inpatient hospitalizations only...
     
  2. goillini52
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    goillini52 MAGA...Eat More Bacon & BUILD THAT WALL!!!

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    That's the way it's supposed to be. Out patient shouldn't count as a hospital stay.
     
  3. Justin Bilyj
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    Should I call and contest? How does that work, never have done that. It was an Equitable express app..
     
  4. vic120
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    vic120 Guru

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    nothing ventured nothing gained. She was declined if you don't call you have nothing. If you call and explain it was not an actual admittance. You have a chance they might listen. I have called other Ins companies to contest on 4 dif occasions and 1 of them I got issued, The other 3 no go
     
    vic120, Sep 30, 2015
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  5. goillini52
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    goillini52 MAGA...Eat More Bacon & BUILD THAT WALL!!!

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    I know it can vary by state, but my app asks if they've been hospitalized more than 2 times...not 2 or more.

    I agree with Vic, challenge it.
     
  6. Justin Bilyj
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    I called up EQ today, told them that only one of the procedures done in the last two years were inpatient, they said they had procedures from 2013 (technically) outside the 2 years, and they said they wanted notes from every doctor to attest they were outpatient.
    I asked her that since there was only 3 procedures within the last two years, didn't she technically need one of those notes to indicate outpatient to qualify based on the application question? She said no, and I had a go around with her about this. Basically I told her the company wasn't following the rules of the application...
     
  7. goillini52
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    goillini52 MAGA...Eat More Bacon & BUILD THAT WALL!!!

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    Was this the same person that DQ'd her the 1st time? Often with 2 different people you get 2 different answers.

    I just called Equitable and they told me that she shouldn't have been DQ'd, that a hospitalization is an overnight stay. I asked if you could call and start a new POS(LOL), and they said no, because she's red flagged. Guess you'll have to get the memos from the Dr. or write it with someone else.
     
    Last edited: Oct 1, 2015
  8. socal401
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    socal401 Super Genius

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    It depends when in 2013 the procedures were done. It has to be more than 2 years. I recently had my first overturned decline by submitting documents provided by a doctors office. If the applicant is motivated to get the lower rate then they will do the extra work to get proof. Also you could just submit it to another company.
     
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