Mater private bill

ck0

My wife checked in for a ‘day case’ procedure which supposed to be covered by our insurance. After the surgery she felt herself very sick and dizzy and was not in the position to go home and stayed in the hospital until the Morning. Now she received the bill for that procedure as ‘Inpatient’ and the amount is Euro 3,797. As per our insurance plan - insurance is covering 50% of the amount. She haven’t signed any additional documentation and hospital never advised on any fees. Is it possible to dispute that amount? Thanks for your advises.

moved to insurance forum

Marcusm

I had a similar issue in Beacon when a day case became an overnight as the anaesthetist wanted to do a spinal block. The additional cost was the overnight room rate which was just around €1,000. Did you get a breakdown of the charges?

ck0

They explained, that as per our insurance plan, the procedure would be fully covered if it was a “day case”. As she stayed overnight they have considered this procedure as “inpatient” and insurance cover for a procedure was only 50%. I tried to ring them and dispute the bill and asked them to charge for “day case” plus for “overnight stay” but they advises that they can’t calculate it that way… That status of the procedure has changes to “inpatient” and it is charged accordingly…

Jim2007

https://www.boards.ie/discussion/comment/121928712#Comment_121928712

That is not going to fly, the only reason she was there overnight was as a result of the operation so expecting it to be charged any other way is not realistic. If this procedure is normally done as an out patient and they set your expectations along those lines, you might see if you can get some movement by arguing that it was an unexpected outcome and they should shoulder some of the cost and of course once you get a foot in the door try to widen the gap.

geecee

I have found the Mater private finance department quite flexible when it comes to bills, but it was usually the consultant who intervened on my behalf. Have you spoken to the consultant?

ck0

no, i spoke to finance department and insurance company. My wife will go for a check up on coming Tuesday and I will advise her to discuss it again with a consultant. Thanks for advising