A couple were told they faced a $200,000 (£146,500) medical bill when their baby was born prematurely in the US, despite them having travel insurance which covered her pregnancy.
A couple were told they faced a $200,000 (£146,500) medical bill when their baby was born prematurely in the US, despite them having travel insurance which covered her pregnancy.
I realise that, my connecting thought was that the hospital looking at their insurance policy should have been able to understand the pregnancy was covered. Even with it being unclear due to the contract’s wording, it should have triggered the billing department contacting the insurer for clarification.
That’s not how America works though, they operate on a ‘invoice first, ask questions later’ approach. If one in a thousand bills get paid without question, the superfluousness is considered justified. Oh well, I would add this to my list of reasons to avoid the country if it weren’t so long already.
You seem confused.
As someone who has worked directly with medical (dental) insurance, the billing hospital/doctor almost definitely sent the bill to the insurance company first, were denied the claim, and then sent it to the couple afterwards.
You seem to think the hospital told them they weren’t covered, but that isn’t what happened. At least not in this article. They thought it was covered and dealt with until returning to the UK, where the insurer told them they weren’t covered.
You aren’t the only one whose work has involved medical insurance.
From my experience, it was quite uncommon for the practitioner themselves to be preparing and sending an invoice to the insurance company. Typically they would pass this off to the billing department, though in smaller places like a dental office I’ve seen the ‘billing department’ just be the front desk. It’s a touch misleading to equate the billing hospital with the doctor as if penning invoices is a shared responsibility between the two with each taking roughly equal part.
In any case, it’s irrelevant. I’m not here arguing minutia about on which continent the responsibility specifically failed, nor whatever individual made an error. The system failed these people, even if the end result was only a momentary heart rate increase from seeing a medical bill until a phone call resolved the issue.
If my underlying point remains unclear, I doubt I can clarify further.