Re: Happy New Year

From: ATB28@aol.com
Sat Jan 22 08:27:19 2000


In a message dated 01/21/2000 7:14:18 PM Pacific Standard Time, jbulley@cheshire.net writes:

<< At Wed, 19 Jan 2000, Geffrey Klein, MD wrote: >
>Interesting Case:
>
>20 y/o G1 who I followed for 36 weeks presented on 12/31/99 with SROM at
>17:30 and was admitted. Pt was started on pitocin and delivered at 9:00 AM
>on 1/1/2000.
>
>Insurance company XYZ refused to pay global fee for the delivery because
>her policy terminated at 0000 on 12/31/99. Any thoughts?
> >>

Geff: She is in an active course of treatment (labor and delivery) and her insurer should be payment the global fee. This is a no-brainer, unless the employer specifically says "no" in the contract. The patient should review her EOC (Evidence of Coverage) should be reviewed to see if delivery is specifically excluded (I doubt it is). Allan





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