.jpg)
Today Robin received a letter from United Health Care stating that the insurance claim for her recent hospital admission was denied.
"The clinical reason for our determination is: Your doctor admitted you to the hospital on 6/26/19. You had trouble breathing. We reviewed the medical information made available to us. We reviewed the health plan's criteria for admission to the hospital. We have determined that this stay does mot meet those criteria. The reason is that you were stable. Your breathing got better. You did not have pneumonia. Your heart was not getting worse. You could have received the care you needed in an observation level at the hospital. Your admission is not covered. Observation may be covered for the admission beginning 6/26/19 in this case, if ordered by your doctor."
I've called the hospital. The nice lady in billing says that they have these battles all the time and of course they automatically appeal rejections. Call back in a week if there are any problems.
The goddamned audacity. "Your breathing got better." When I am sitting here crying over her box of ashes.
"The clinical reason for our determination is: Your doctor admitted you to the hospital on 6/26/19. You had trouble breathing. We reviewed the medical information made available to us. We reviewed the health plan's criteria for admission to the hospital. We have determined that this stay does mot meet those criteria. The reason is that you were stable. Your breathing got better. You did not have pneumonia. Your heart was not getting worse. You could have received the care you needed in an observation level at the hospital. Your admission is not covered. Observation may be covered for the admission beginning 6/26/19 in this case, if ordered by your doctor."
I've called the hospital. The nice lady in billing says that they have these battles all the time and of course they automatically appeal rejections. Call back in a week if there are any problems.
The goddamned audacity. "Your breathing got better." When I am sitting here crying over her box of ashes.
No comments:
Post a Comment