does stop loss apply to out patient claims?

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PostPosted: Fri Oct 10, 2014 4:13 pm   Post subject: does stop loss apply to out patient claims?  

I have an insurance who paid & now wants to recoup monies and leaving patient responsible for zero. Due to stop loss


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PostPosted: Sun Oct 12, 2014 2:51 pm   Post subject:   

Makes no sense. If a stop loss for medical expenses has been reached, the insurer is responsible for all remaining covered expenses for the year.

Insufficient information to provide a better response.



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PostPosted: Tue Oct 14, 2014 12:12 pm   Post subject:   

Stop loss policy is one of the most crucial elements for a self insured plan. This policy is fairly straight forward, it is having around fifteen pages with relatively small amount of exclusions.

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PostPosted: Tue Oct 14, 2014 4:12 pm   Post subject:   

Quote:
Stop loss policy
Does not have any applicability to the OP's question having to do with individual health insurance which is NOT a self-insured plan.


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