Who pays? The hospital received authoration for a procdure, from the wrong insurance!? -

The bill is in the appeals process. The hospital obtained authorization from the insurance HMO we used last year. The procedure was done. The PPO we have this year from the same company, same ID numbers etc. refuses to pay. Ultimately, it's whoever received the service, that's supposed to pay for it. That's YOU. What you're going to need to do, is appeal the denial. Get the "authorization" number from the hospital, write up a written request for appeal, call your insurance company, ask if the procedure can be authorized after the fact (many times it can), and explain exactly what happened. If this is something they would have covered, if you had preauthorized it properly, they should pay it now. IF they still refuse to cover it, you need to write a complaint letter to your state insurance department, saying something like, the wrong company authorized, the right company would have paid it, it was medically necessary, please review. Then CC the right company in on it. did the hospital have the new insurance company on file, cause if they did the hospital should pay , but if they didn't than you'll have too. not you................they will bill you .don't pay.not your fault.......... It sounds like you're the victim of administrative incompetence on the part of the hospital. If preauthorization was required, your new insurance (PPO) is within its rights to deny payment since its preauthorization was never obtained. The fault here is the hospital's, so prepare to so battle with them. I had something similar happen once. The lesson I learned is to insist that the provider give ME a written copy of the insurer's preauthorization beforehand. Never, never take the verbal word of anyone at the provider that "the paperwork's in order." Be an a**hole and demand written proof. Sorry you have to go through this. (Source: experience.)