Conflict With Two Insurances?

Question by kmo0406: conflict with two insurances?
my fiance was admitted to the hospital in august because he was 1) under the influence of alcohol and 2) under the influence of legal weed. while he was in the hospital he was diagnosed and treated for a potassium deficiency. when we received the bill a month later we filed it through his major insurance BCBS of AL, and a few weeks after that BCBS denied it because it was filed under “substance abuse” the insurance coverage he has also has a second provider known as behavioral health services, and BCBS said they cover claims labeled substance abuse. Now BHS is denying the claim because it’s not considered substance abuse because the treatment he received was for the potassium deficiency. the bill is close to $ 3500 and we just don’t have that kind of money. how can we get one of the insurances to cover it, when one is saying it’s substance abuse and the other is saying it’s a medical problem?

Best answer:

Answer by Bill
Contact the insurance company and file a challenge to their initial decision. They will give you a hearing where you can explain the situation and request reconsideration. Many times claims are denied because the medical provider did not clearly explain the condition or treatments. Good Luck

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