Doctors told her she\u2019d need surgery at CommonSpirit Holy Cross Hospital \u2013 Salt Lake, but it\u2019s out of her insurance network.<\/p>\n
\u201cThey were the only hospital with the right laser equipment to do the procedure,\u201d she explained.<\/p>\n
Brown braced herself for a higher co-pay and deductible. And she said the hospital told her she\u2019d have to pay upfront, but her medical insurance provider\u2019s out-of-network benefit would reimburse her a portion of that money.<\/p>\n
So, she paid nearly $5,200 and got her voice back. However, her insurance now won\u2019t reimburse anything. She said they\u2019re telling her that the hospital\u2019s itemization is not sufficient due to medical codes.<\/p>\n
\u201cMissing diagnosis codes, missing procedure codes,\u201d Brown read from the denial letter.<\/p>\n
![\"Lori](\"https:\/\/www.europesays.com\/us\/wp-content\/uploads\/2025\/10\/MEDICAL-CODES-CLIP-TWO.jpg\")
<\/p>\n
Lori Brown tells KSL\u2019s Matt Gephardt the hospital will not present her insurance provider the codes it needs to reimburse her for a procedure. (Istvan Bartos, KSL TV)<\/p>\n
Now, there are medical codes in the documentation the hospital gave to Brown, but they\u2019re not in an industry standard that her insurance recognizes. She said that despite all her calls, she can\u2019t get the hospital to send her a new itemization with acceptable coding.<\/p>\n
\u201cIt\u2019s like, why?\u201d she said. \u201cThat\u2019s ridiculous.\u201d<\/p>\n
So, her next call was to Get Gephardt.<\/p>\n
Code resolution<\/strong><\/p>\n And the KSL Investigators contacted the hospital\u2019s owner, CommonSpirit. We asked why she cannot get an itemization using codes her insurance will accept.<\/p>\n A spokesperson told KSL it\u2019s because Brown paid up front, the hospital didn\u2019t generate its regular claim form that an insurance company would use. They apologized for the misunderstanding and said they would refund her what she had paid and then bill her insurance directly for the treatment.<\/p>\n The spokesperson also insists the process was started weeks earlier, before Brown called me.<\/p>\n That was news to her. She said she wasn\u2019t told about the refund or the new insurance billing until after we got involved. Either way, she now has her money back.<\/p>\n \u201cIt just seems so simple,\u201d Brown said.<\/p>\n