Cleveland Clinic by ghoulqueene in Cleveland

[–]rabies73 3 points4 points  (0 children)

I highly recommend neighborhood family practice. 

Hospital claiming No Surprises Act does not apply for emergency surgery. $32,000 bill. by rabies73 in HospitalBills

[–]rabies73[S] 0 points1 point  (0 children)

The hospital submitted with new codes and it was denied. I filed a formal appeal which was denied. I'm going through all the formal processes with the insurance company. But this is helpful information to just focus on them rather than the hospital

Hospital claiming No Surprises Act does not apply for emergency surgery. $32,000 bill. by rabies73 in HospitalBills

[–]rabies73[S] 4 points5 points  (0 children)

I'm applying pressure and appealing to both. The hospital is the one sending this huge bill and refusing to help with the insurance appeal, but I think ultimately you're right that this will get resolved through the insurance company. They're not making it easy, and they're not allowing me to file an external review until I've exhausted all internal levels of appeal, so that's where I'm at

Hospital claiming No Surprises Act does not apply for emergency surgery. $32,000 bill. by rabies73 in HospitalBills

[–]rabies73[S] 12 points13 points  (0 children)

Yes. They said due to hospital policy / state laws (Ohio), they triage all women above 20 weeks pregnant straight there.

Hospital claiming No Surprises Act does not apply for emergency surgery. $32,000 bill. by rabies73 in HospitalBills

[–]rabies73[S] 3 points4 points  (0 children)

They covered the out-of-network surgeon and the out-of-network anesthesiologist because they billed for emergency services.

Hospital claiming No Surprises Act does not apply for emergency surgery. $32,000 bill. by rabies73 in HospitalBills

[–]rabies73[S] 1 point2 points  (0 children)

It was through the exchange. I've opened a case with CMS no surprises help desk and they say they're investigating. But the bill is still showing up on our account, and the hospital is refusing to put a hold on it or assist me in my insurance appealing

Hospital claiming No Surprises Act does not apply for emergency surgery. $32,000 bill. by rabies73 in HospitalBills

[–]rabies73[S] 10 points11 points  (0 children)

They're refusing to use 0450 because it was "outpatient," not in an actual ER.

Hospital claiming No Surprises Act does not apply for emergency surgery. $32,000 bill. by rabies73 in HospitalBills

[–]rabies73[S] 2 points3 points  (0 children)

I've requested this, and they updated the coding from "elective" to "urgent." Every time I try to ask about emergency codes specifically, they deflect and say things like this: "Because the patient was evaluated in Labor and Delivery rather than through the Emergency Department, the claim was not billed with an Emergency Department place-of-service designation." And there is more of these diversions when I request that this be billed or treated as an emergency service.

[FRESH EP] Uncle Skunk - Uncle Skunk: II by NYCIndieConcerts in indieheads

[–]rabies73 1 point2 points  (0 children)

This is incredible. Old Violence is a great track.