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Problem Solved: Hospital Stay Reimbursement

If you have a story idea, or a problem you think we may be able to help you with, send 3 On Your Side an email.

DELAWARE (CBS)--Does fighting with insurance companies about medical coverage sound familiar? One Delaware grandmother was supposed to be reimbursed, but wasn't. And she says nobody would listen until 3 On Your Side Medical Reporter Stephanie Stahl got involved.

64-year-old Renee Llewellyn spent three nights in the hospital for testing to determine what was causing her excruciating pain.

"From my waist to my knee, just like somebody took a knife and just kept poking," described Renee. That pain subsided, and they never did figure out what was causing it.

The New Castle grandmother quickly faced a different kind of pain. Renee had a hospital indemnity plan that covers some in-patient hospitalizations. But Aetna refused to pay.

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Renee was told, "You didn't stay in the hospital. I said what are you talking about? They said, 'Oh no, it's on here as an outpatient.'"

The hospital bill clearly lists overnight services, but it was totaled under the category of observation.

Renee said, "That's the folder that they give you when they put you in a room."

Stephanie replied, "This is like the welcome to the hospital room folder, that they said you were never there?"

Renee said, "Exactly. I went to the hospital and they told me that that's the way it was written up. There is nothing they could do. I called Aetna they said that's the way it was written up, and it was the hospital's fault. The hospital said it was Aetna's fault."

That went on for months, until Renee got in touch with 3 On Your Side, and we called Aetna.

"Look how fast they just changed. Nobody wanted to listen to anything until they were called from Channel 3," said Renee.

A short time later Renee got a check for $1,300.

"The lady called me on the phone and said, 'We changed our mind because we didn't want to see you suffer. You deserve this money.' I'm thinking, okay. If it wasn't for you I would never have seen that money. It's a miracle. It really is, and you don't know how much I appreciate it. I really do," said Renee.

A spokesperson for Aetna told Eyewitness News they never received a claim for an inpatient hospital stay. Once we brought the problem to their attention, they had Renee file an appeal and moved quickly to reimburse her.

Aetna says that if she had filed an appeal on her own, working directly with them, she would have had the same result.

Reported by Stephanie Stahl, CBS3

If you have a story idea, or a problem you think we may be able to help you with, send 3 On Your Side an email.

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