I recently worked with a case where the person gave birth and since the provider was outta network, they were billing her only $15,000. I was able to prove by sufficient medical records and a review of the health insurance policy that she should have been covered for this provider, even though they were out of network in the long run, the $15,000 was paid for her pregnancy. Sometimes you need to prove the level of documentation, sufficient medical records, and if it’s APPO plan, they definitely should be covered no matter what. If you ever need help, please call me Adria at Medwise Insurance Advocacy.
