Blue Cross Blue Shield is claiming Im out of network, how can I challenge this denial?

Blue Cross Blue Shield is claiming Im out of network, how can I challenge this denial?

My sister and I were in a serious auto accident and were taken to Brackenridge trauma center. BCBS of Texas is claiming only the first 48 hours in the trauma center are covered. My sister was unconscious, and I was heavily medicated for the first 72 hours. What is the best way to challenge this denial?

MrNeutra

The reason you are out of network is the hospital is not participating in the very poor reimbursement paid by BCBS. The hospital is gambling that the auto accident insurance may pay them better, You can bet their charges will be hugely over bloated. (Hospitals take monstrous discounts on their fees when they accept insurance as payment in full). If the wreck wasn't your fault, a lawyer will help straighten this out for a piece of the settlement. They can induce the hospital to take a discount. If you are still hospitalized, get out ASAP. As the previous answer as suggested, you may have to speak to a customoer service rep. Make sure you completely document every conversation and contact in writing including time date and persons name. Good luck. You can prevaail.

TKS

You will need to ask BCBS of Texas you want to appeal and find out what additional infomation they need. You will also need to contact the Brackenridge trauma center, tell them that your insurance is denying after the first 48 hours and ask them to refile with additional information that you mentioned. It may be a long drawn out process and you may not change their mind but definitely try. You can also ask your state attorney office for help if it gets really bad.

Ask

insurance

Popular Q&A

Can you help me find a commercial auto insurance company?
Look, your attorney, who you're hiring, has connections to find someone who can do this.See, the vast, vast majority of people who think about doing this, can't afford it.If you came to ME asking for a quote, I'd charge you a $1,000 brokers fee for my time, because odds are very, very slim...

What are the top 10 best nationally renowned auto insurance providers?
According to the July 2010 issue of Best's Review, the top ten property/casualty (includes auto) writers are:State FarmAllstateBerkshire Hathoway (owns Geico)Amerian International Group (owns/owned 21st Century)Liberty MutualTravelersNationwideProgressiveFarmersUSAA

If a chiropractor got paid 100% by my Medpay, Can he get paid again by the 3rd party insurance?
The other insurance company, liable carrier, will require medical bills and records to evaluate your claim. Depending on your state, will determine how the rest of the claim is paid. If your insurance carrier, Allstate, is allowed subrogation rights by law, then they will put the at fault...

What are you paying for ur car insurance?
That sounds like a bargain for a new $31,000 dollar car.I'm 41, have a clean record in Missouri and pay $118.00 a month for full coverage on a 2001 Town Car, '69 Camaro and 2007 car trailer and liability on a 1987 Suburban 4x4. Total value minus the truck is about $30,000. The Camaro is actually...

Can anyone help out with a broker that deals in high risk auto insurance in Toronto?
Almost every insurance broker in Toronto will have access to one or more non-standard auto insurers. Google auto insurance brokers in Toronto and start calling.