A few months ago I had a climbing accident and was stuck for 12 hours in a slot canyon (literally wedged between two rocks), and had to take a helicopter to the hospital once I was rescued. After arriving at the ER, I was admitted to the ICU for kidney failure.
About 12 hours later, a hospital representative came and collected my insurance information. I had just started a new job and had not yet received my cards, so I gave the man all the information that I had as well as gave him my parents insurance since I am still under 26. The next day we checked with the hospital and confirmed that everything was all set insurance-wise, and they said there were no issues.
About a month later I receive a bill from the hospital saying my claim was denied due to lack of pre-authorization. According to my EOB, my insurance paid about $3k of the $36k bill. I sent in a grievance letter and they responded saying the claim was still denied.
I have a legal advocate through my company who is going to try and do some research into this and the hospital said they will also try to appeal it. My question is this – if the claim is ultimately denied, is the bill going to end up being my responsibility? I would have called my insurance company had the hospital informed me that there was an issue with obtaining the pre-authorization, but since they told me everything was fine, I assumed that it was. Unfortunately, I don’t have any proof that they said they obtained the authorizations, all I have is an email to the hospital rep with my insurance info. I’m also curious why the insurance paid a small portion but denied the rest? They literally paid a tiny chunk of every line item on the bill.
Is there anything that I can do? I just filed bankruptcy this year and I really don’t want to have another 36k in debt dropped on me.
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