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How To Review A Hospital Bill And What To Do If You Find An Error

Insureds With Bills For Care Provided In The Hospital By Doctors Who Are Not In The Plan's Network Or Whose Services Are Not Pre-Approved

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People in a managed care plan may be denied coverage for services provided in the hospital by doctors who were not in the company's plan and not pre-approved. If this happens to you, you have to deal with the insurance company rather than the hospital.

First determine whether the doctor actually provided some sort of healthcare. If you kept a log, it will be easy to find this out.

If the doctor did provide a healthcare service, call the phone number on the statement and ask if the doctor has an agreement with your insurance company.

  • If so, call the insurance company and point out the error.
  • If not, call the insurance company and explain that you were attended by the doctor while you were in the hospital and that you had no control over which doctors treated you. 
  • If a call doesn't work, consider using the insurance company's system to appeal. You do not need a lawyer to appeal. 

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