AboutMerry Schiff Expertise I am very familar with Medicare and general insurance questions. I can answer general questions about HMO's.
Experience I have been in the medical billing industry for 50 years. I have helped develop software for this industry. I am a consultant to billers and the medical profession.
Organizations I am the Executive Director of NEBA, a medical billing organization with nearly 1000 members.
Education/Credentials I have been teaching medical billing for many years as well as being a published author with Pearson Education. One book on medical billing (nearly 800 pages) and one on HIPAA.
Expert: Merry Schiff Date: 7/3/2008 Subject: unpaid maternity bill
Question My daughter was born a year ago and we had all the maternity expenses covered through my insurance but I left my job a month after her birth. We put everyone onto my husband's policy. The hospital billed my insurance for the birth and the insurance paid for me but denied her essentially we were intiially told because they pay on a mommy-baby case rate. The hospital had billed the insurance company seperately for us. We are now looking at possibly having to pay her bill, but we recently submitted it to the insurance company that she was covered under at the time of her birth which will considered claims up to two years from the initial date of service. I found out today that they initially denied the claim because they need more information from the provider.
Are we responsible for the bill considering my insurance company was supposed to cover my benefits 100%? Any advice would be appreciated.
Answer I would find out exactly the information needed from the provider and be sure that they do it. I would get the requested info and you yourself submit the info to the insurance com. And find a supervisor that you can do this with. If yu are going from a group to a group policy with no lapse, you should be covered.
