Hospital ignored requests from insurance company for justification for appendectomy, they denied it. Will I have to pay?
Location: Massachusetts. I had my appendix out last month in an emergency type situation at a local hospital. I was in acute pain and was told the scans showed appendicitis and that it had to come out. I was in the hospital for around 12 hours from around 9 pm to 9 am. Today, I received a notice dated 06/01 from my insurance company stating that they had denied the procedure due to lack of response from the medical provider regarding documentation of medical necessity. They stated that they had reached out to them multiple times and the provider had failed to respond. They stated that I had 30 days from the time of the notice (I had been away the past two weeks so just received it today) to get the provider to respond to appeal the decision, and when I messaged the doctor, I got a vacation response stating that they would be away until the 28th. Im guessing that they went on vacation and missed the notice, my question here is will I be liable for the 60k bill if the provider fails to respond?