Good suggestion. I've got a suggestion that kind of builds on that. If you insurance company has a website, you should be able to find out from the website what hospitals/ clinics are part of their network. Many insurance websites have a search function that allows you to put in an address and the type of care you are looking for. Then it makes a list of the in-network places close to that address for that type of care. Sometimes the list will even be organized by distance and have links to maps. That way, you would have all the information you need before you go.LMC said:If you get the exact names of these hospitals/clinics then you should be able to call your insurance company to see if they are covered in your "network".
They should cover it the same as they would if it was an in-network hospital if the child needed care (but it may take 2 or 3 denials and re-submissions to get that). The insurance companies bank on the fact that most people don't re-submit a claim at all if it's denied the first time. And, each time it's denied, less re-submit. Most insurance has a "reasonable person" type clause about seeking care. They may say a reasonable person would have taken the child to a doctor, but not necessarily the ER. I think most reasonable people would take an infant with a 106+ fever to the ER (and if you called a doctor first and were told to take them to the ER, that's more evidence).LMC said:I always assumed the any emergency trip was covered by insurance but I learned years back when taking an infant with a 106+ fever to an ER that all hospitals are not covered!
My experience was that it went under major medical first since it was an out of network hospital and I had to pay my maj med deductible before any insurance would kick in.