Plan rejects $45,000 bill; now what?

My brother had an accident in Florida. He is a student from India (country of citizenship), studying in Pennsylvania and covered by international student insurance. His insurance card was presented at the time of check-in to ER. He was in ICU for 2 days. A week later he received bills from hospital worth $45,000 and a letter from insurance company that the hospital claims were rejected. We are both international students with no income and on F1 visa. What are our options?

Far From Home

Dear Far From Home,

First, contact the insurer and find out why they rejected the claim. It might be something as simple as a billing error by the hospital or an administrative mistake. If not, there should be a process to have the company reconsider the claim. The hospital’s business office will be motivated to help you pursue the insurance company; so ask for their help to have the claim reconsidered.

You did not describe the accident, so it’s possible that the claim was rejected because whoever caused the accident is expected to pay first. If your brother was hit by a car, for example, the driver’s insurance is supposed to pay first.

In short, don’t give up on having the plan pay the claim until you go through their appeals process.

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Linda Riddell

About Linda Riddell

A published author and health policy analyst with 25 years’ experience, Linda Riddell's goal is to alleviate the widespread ailment of not knowing what your health plan can do for you.