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Hello, Every insurance policy is different so even if your friends policy paid doesn't mean your mothers policy will pay. First get a copy of her insurance policy and go the hospitals financial assistance or billing department and they should able to look over the policy and see if your mother is covered, it may just be a matter on how the charges are coded that makes a difference. If the hospital says that you should be covered by the policy and your insurance company still refuses you would contact your state's department of insurance to make a complaint. Thanks Tom
so even if they are in the same location how can they pay for one and not the other
All insurance policies are different and coverages are different
the thing that keeps bothering me is the fact that they kept telling them that they were not going to pay for their family member either and then they paid
They maybe how the stay was coded, most policies will not pay for nursing home care unless is for rehabilitation and limit how many days they pay for hospital care. Is your mother old enough for medicare. Thanks Tom
yes she has medicare but medicare will not pay for this
Why is she requirted to stay in the hospital?
that what the problem is . she is in A hospital but she is in a long term care bed that she can stay in for as long as she needs to she had a stroke and requires 24/7 care.she has nothing to do with the hospital .she is just like she in a nursing home.
I understand, does the nursing home section of the hospital operate under a different name?
no it is all the same and that is why the insurance will not pay because they keep telling me she is in a hospital
We are back to where I started, the hospital since it is unique with a nursing home inside a hospital is should know how to handle the situatiuon. They will know how to bill the cost so that your policy covers the stay. It is how the bill is coded, if you visit their billing or financial assistance department they should be able to help you.
i am sure when this policy was written there was no such thing as having long term care beds in a hospital but now it is. thank you for your help