- Staff
- #1
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A client of mine just told me the following about her mother:
She lives in New York and is a widow. She is 67. She has a Blue Cross PPO through her employer. (True group plan) She is the primary on the contract. She has a precertification requirement on her policy.
She was recently hospitalized (In network) with some kind of inflammation on her brain. She was obviously in no position to call the insurance company to do a precert.
Her daughter went with her, but had no idea about the requirements. At admissions, she asked if there was anything she needed to do and they said no. (I know, that makes no difference to the insurance company)
Blue is denying all of her claims and has already rejected one of her appeals. They are telling her that she needs to pay everything, and also that she needs to appeal each and every specific claim, or she loses her right to appeal any of them.
Any advice would be appreciated.
She lives in New York and is a widow. She is 67. She has a Blue Cross PPO through her employer. (True group plan) She is the primary on the contract. She has a precertification requirement on her policy.
She was recently hospitalized (In network) with some kind of inflammation on her brain. She was obviously in no position to call the insurance company to do a precert.
Her daughter went with her, but had no idea about the requirements. At admissions, she asked if there was anything she needed to do and they said no. (I know, that makes no difference to the insurance company)
Blue is denying all of her claims and has already rejected one of her appeals. They are telling her that she needs to pay everything, and also that she needs to appeal each and every specific claim, or she loses her right to appeal any of them.
Any advice would be appreciated.