Medical billing challenges

Kaiser Health News reported on a couple's difficulties with a medical bill when their newborn twins required neonatal intensive care. The No Surprises Act requires insurance companies and providers to work out payment when patients end up at an out-of-network provider for an emergency. However, this article details some difficulties that can arise when the insurer denies that medical services were provided in response to an emergency.

It is unclear why the hospital in this case appears to have been reluctant to have billed the services as emergency services. The article seems to suggest that the hospital might have been following some internal protocol, given that the infants were not literally checked in via the emergency department (but rather through a doctor). However, once the couple alerted the hospital, it is unclear why they refused to amend their claims. It also seems odd that the insurance company seemed so ready to deny that neonatal intensive care immediately after birth was for emergency purposes. Regardless, it is unfortunate that patients find themselves needing to turn to consultants to navigate such billing challenges.