Question
What is the name of your state?
Florida
My wife went into the hospital in September 2006. Her treatment was preauthorized by United Health Care which was my company's insurance carrier.
UHC paid the bills. So far so good.
The company went out of business sometime around October 2006 - and did not pay the premiums for September.
UHC is now revoking it's preauthorization and demanding the money back from the hospital and doctors.
If anyone has any experience with this, I would love to hear from you.
Charles
[email]focus@clixforbrix.com[/email]
Answer
A pre-authorization presumes that coverage will be in force at the time the procedure is done.
If no premiums were paid and coverage was cancelled due to non-payment, they are not required to make exceptions for pre-authorized procedures.
Answer
That really stinks but CBG is right (of course), the disclaimer on the pre-certs (and in your policy too) say that it's not a guarantee of payment. Coverage must be active at the time of service in order for claims to be paid.
You *might* be able to hold your former employer liable for some or all of the cost, EXCEPT that since the company is out of business and probably bankrupt, so they don't have any money to pay out. Your best bet is to explain the situation to the doctors/hospital and try to negotiate the bills down and work out a payment schedule.
You *should* get back any money that was taken out of your paycheck going towards the premiums for September, but again with the defunct business, whether you actually will is questionable.