Worries after inpatient stay
Hi all,
My loved one went to an in-network hospital in CA for a mental health crisis. They were admitted on a 51/50 hold, but the hospital didn’t have the care they needed and forcibly moved them to another facility out of town. The social worker assured us multiple times this would be covered as the “same emergency room event” under the No Surprises Act. We paid the copay then and there.
Once discharged from the second hospital, they got a text from the original hospital (like the very minute we discharged) saying “thanks for your stay at [in network hospital].” However, on the second hospital paperwork, “self pay” was marked. My loved one gave them her insurance card and explained the situation, and another social worker said it’s likely fine because the original hospital is responsible for making it right. They asked to see a billing person while on the hold and no one ever came.
I called their insurance on Friday who said it should be covered and that they have full behavioral health coverage. They’re waiting for the facilities to reach out. It’s the weekend so we can’t call to deal with it all yet because customer service is closed, but my loved one is feeling traumatized by the whole event and the last thing I want for them is a catastrophic bill. Will we be ok?
Their company is western health advantage. They have a strong plan as a state employee but are limited to local facilities. The original hospital seemed relieved and confident when they found out their insurer is WHA.