• Insurance problems - coding issues?

    Asked by LeroyPerseHK on Monday, September 16, 2019

    Insurance problems - coding issues?

    I am repeatedly getting notices from my hospital and insurance company saying this or that wasn't covered. I have no reason why. One time the insurance will say it wasn't "coded" correctly. If they know that's the problem, why don't they fix it? The hospital says it coded what they were told to. It's like nobody talks to each other.

    Another thing. I was in the hospital for 2 days, the hospital said I was there for "observation" and not admitted. I was put in a room, stayed two nights, was brought meals, had a nurse, doctor came by to see me. If it looks like a duck in a hospital, it is a duck in a hospital. It cost me 500.00 a day from another insurance policy I have, but since they say I was in "observation" it didn't pay. This is a bunch of crap!

    8 Answers from the Community

    8 answers
    • carm's Avatar

      23 hours or less is considered observation.

      9 months ago
    • GregP_WN's Avatar

      Carm, I was in the hospital for 2 days when I had an issue with this. It was when I had a TIA. My situation was just like Leroy's. I have let things like this go time and time again just because I don't have the energy to fight it most of the time.

      9 months ago
    • Dawsonsmom's Avatar

      GregP, I think the insurance companies count on exactly what you did....let it go bc you don’t have the energy to fight them. It’s totally ridiculous and uncaring. Insurance companies are in the business of collecting premiums and denying as many claims as possible. They are every bit as greedy as big Pharma. While it’s not great being old enough for Medicare, I have to say that they have been great w paying docs and hospital. This far, I have paid approximately $36.00 out of pocket.

      9 months ago

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