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Infolawyer, Lawyer
Category: Consumer Protection Law
Satisfied Customers: 6823
Experience:  Licensed attorney helping individuals and businesses.
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On 4/11/2015 I began experiencing stroke-like symptoms and

Customer Question

On 4/11/2015 I began experiencing stroke-like symptoms and my wife took me to the ER. They ran a bunch of tests MRI CT etc. The medical claim for that visit was approved.
On 4/15/2015 I began experiencing the same symptoms and they ran more tests MRI CT etc and my claim was denied stating it was medically unnecessary.
I have gone through the Blue Cross Blue Shield internal and external appeal process. The first two internal appeals upheld the decision of denied and the external appeal also held up a decision of denied. The reason in all three cases stated medically unnecessary. BCBS is not being consistent. What legal action can I take against the hospital or the insurance company?
Submitted: 1 year ago.
Category: Consumer Protection Law
Expert:  Alex J. Esq. replied 1 year ago.

Hello. My name is***** am a US licensed attorney and I will be happy to answer your question.
I am sorry to hear about this unfortunate situation.
Please note, I cannot comment on your specific situation, as this services is only limited to general information and for any legal advice / legal service you should contact your local attorney.

What is the amount of unpaid medical bills?

Customer: replied 1 year ago.
The claim was for over 17K but since the claim was denied the hospital cut the bill in half so it's about 9K. The first claim they approved was for about 25K and my responsiblity for that claim was about 6K. I'm confident I would owe less than 5K on the second claim if it was paid / approved by BCBS.

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