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Claim issues Hi, My parents visited me in US for 3 months. During their stay my mom had to be taken to the emergency room and was detected with gall bladder stone. She was at the hospital overnight in the ER and underwent countless tests which the doctors had suggested. Finally she was released after the diagnosis as I did not agree to get the operation done right away. Now the final bill hospital came up with was a whopping 22K. I forwarded the claim and documents to the insurance company. I got explanation of benefits from the insurance which was not that clear but all I could make out is that they paid only few hundreds from the huge claim. Today I got another statement from the hospital that the total bill is still 22K+ and i am supposed to pay a discounted amount of 5.7K. Still this amount is too big for me. Is there any way I can negotiate with either Insurance or Hospital? Please let me know. Thanks, Mano
From the limited information you have posted, it seems that you might have purchased a fixed coverage plan. Therefore, the insurance company has paid a limited amount. That is why we always recommend everyone to buy only the comprehensive coverage plans. Anyway, if the bil lis 22K+ and if the hospital is asking you to pay only 5.7K, that is a very big discount that I have ever heard directly from the hospital. You can see if you can further negotiate with them but I find it unlikely. You will have to pay that bill. And next time, please please buy the comprehensive coverage plan only.
Well comprehensive coverage plans are expensive and going by the trend I never thought i have to take my parents to the hospital. I think the hospital did some unnecessary tests which were real expensive. 5.7 K is still too much for me. Do you think anything can be done to reduce this burden?
What you pay is what you get. Insurance is for unforeseen and unpredicted events. You never thought that they would need to go to the hospital, but they had to. That is what the insurance is for. If fixed coverage plan were enough, there would be no reason for comprehensive plans to exist. You can talk to the hospital to see if they can reduce the bill further.
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DISCLAIMER: Information presented in our Questions and Answers section is generic and was deemed to be accurate at the time of response. Please use the answers as a guide and do not make decisions based on the answers. The answers presented may be outdated and altogether inaccurate currently or not relevant as the details provided such as the insurance terms and conditions, plan benefits, eligibility and coverage may have changed. Insubuy assumes no responsibility for relying on such answers. You should review the latest certificate wording of the insurance policy (available on this website) for the product you are considering for the latest and complete details. If there is any conflict between the answers provided here and the certificate wording, the details of the certificate wording will prevail.
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