Procedure Done At Hospital, Told It Would Be Covered By Medicaid. Hospital Did Not Submit Claim Until Now, And Have Stopped Taking Medicaid.
Location: New York.
Posting on behalf of a friend.
My friend had surgery in June 2025. They made sure the hospital accepted Medicaid, and were told by the hospital and insurance it would be covered. Their Medicaid coverage was established and current then and now.
The hospital sent a message a month after the procedure notifying the patient that they were no longer accepting Medicaid. There was no mention of the fact that they apparently had not submitted the claim yet, so the patient assumed that it was a routine notification they sent all patients on file.
Today the patient received a message from the hospital that they owe the full cost ($2,500) for the procedure.
They will be contacting the billing department when they open again on Monday. We would appreciate any guidance to make sure we go into that conversation informed about our legal protections or, if necessary, next steps.
Thank you so much for your time.
Edit to add, this was a revision of a botched procedure this hospital had previously done. The hospital submitted the original claim themselves with no action required from the patient, and they were not told by insurance or the hospital that action would be needed this time.
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