Out of Network Question

[avlavl]

My husband has Health Net insurance and had an accident around February 2008 (broke vertebraes in neck) was rushed to the nearest hospital where they worked on him and then transferred him to another hospital for further work up and that hospital happens to be out of his insurance network. We were unaware of this at the time of admission. HealthNet keeps dening their claim which is thousands of dollars and we cannot afford to pay this. What does one do in a situation like this? Had we known this particular hospital was out of network, we would have suffer the consequences and took him to a hospital that was in network. But injuring your neck is serious and we had no choice.

 

[Crabcake Johnny]

If it's deemed a medical emergency, going to any OON facility is treated as being in network. Fight. I'd suggest filing a complaint with your department of insurance. Also, do you have an agent? They should be able to help fight this.

 

[avlavl]

I just wrote a letter to the insurance case manager. I'll see what she can do.

 

[Crabcake Johnny]

This is absolutely a case where the squeaky wheel gets the grease. Do everything you can - call claims, file a DOI complaint, work with your agent, etc...On their end they're hoping you just go away. Don't.

 

[hn_bradkieffer]

I'm with Health Net ... if you send me your husband's Health Net ID number, I'll check to see if there's anything more that can be done. My email: [email protected].