Question re medical reimbursement

[momqat]

I was on the Westerdam's New Year sailing and came down with Noro virus or something similar (very ill with abdominal "distress" from both ends :eek: ) . During the middle of the night, trying to return to bed from the bathroom, I passed out. My husband called the nurse, who came to the cabin and spent a good hour or so with us. We received a bill for the "cabin call" and submitted it to our insurance. (I did have travel insurance, but looking over the policy, there is a $50 deductible, and the charge is $54 so it really doesn't pay to submit). Anyway, our regular ins. denied the claim because the statement we have from HAL does not include any procedure codes, and no insurance carrier I know of will process a claim without them. I was all set to call the HAL Medical Dept to request them but noticed a big "PLEASE NOTE:" on the bottom of the statement that says, "Holland America Line does not have access to procedure codes (CPT)/ICD-9 codes/RVS codes or 1500 forms/UB82 forms/40-1 forms."

 

OK, now what? Am I in the middle of a Catch 22? I know people have been reimbursed for medical expenses -- how did you handle it?

[jhannah]

I believe the key is your acknowledgment that the difference in deductible and billed charges isn't enough to mess with it. Even if you had the codes for your private insurance, and assuming they would pay for offshore treatment, then you would still have a copayment. The difference would still not net you much for all the trouble.

[sail7seas]

I'm impressed at the moderate amount of the charge.

 

I don't think reimbursement from HAL is to be expected. I, also, contracted NLV on board but would not think it any responsibility of HAL.

 

If I caught a cold (which is the only thing more common than NLV), I wouldn't expect HAL to bear any responsibility.

 

I understand that your question is about your personal insurance and travel insurance and the fact HAL did not enter a code.

 

It's a shame when we get ill while traveling but it does happen sometimes.

 

Hope we both are luckier next time. :)

[dakrewser]

Can you not look up the procedure code yourself, then?

[the2ofus]

I think the OP is asking a valid question. Assuming that there was a larger medical bill for services on the ship, how have other folks been reimbursed if there was no ICD9CDM code? If the ships medical staff does not provide a code, can you ask your family doctor to give you a code? Will the insurance provider accept that or do they even care who provides the code?

 

I can understand why they don't provide the codes because medical coding can be very tricky. One wrong digit or decimal point and the diagnosis and code don't match. Medical records personnel spend hours and days on training for coding and must constantly upgrade their coding skills.

[momqat]

Thanks for your responses.

 

JHannah, my copay is minimal, so it would be worthwhile to persue, but, as I stated, without the codes they won't process it.

 

S7S, yes, I was impressed that the charge was so moderate! But it doesn't negate the fact that my insurance is willing to reimburse as long as I provide the necessary paperwork, which I can't do because HAL does not provide. (BTW, it never even occured to me to expect reimbursement from HAL. They have been paid and that is only fair. But if I am ill and go to my doctor at home, my medical insurance pays for the visit. Likewise, they would reimburse me for this visit, too, if HAL would only cooperate and provide the codes.)

 

I suppose at this time another call to my insurance carrier is the next step, to see if they have any suggestions on how to procede and if I have any alternatives. I would like to know what people who incur large medical bills while aboard ship do to get their insurance reimbursement, and if not providing necessary information is the norm for the cruise industry.

[SHayesShip]

I incurred a medical bill of almost $1,100 on a RCI ship last year. My personal insurance does cover me offshore. Thankfully, the ship's doctor gave me complete paperwork which had all of the coded treatments on it. I turned it into my insurance company upon return and 45 days later got a check minus my $30 co-pay. I think this is very odd that HAL does not do this.

Steve Hayes