Do I need preapproval for emergency surgery?

I recently went in to the emergency room in the middle of the night with intense abdominal pain and was admitted with a severe case of appendicitis.  They had me in for surgery a few hours later.  Now my insurance is only paying half of the claim because I didn't call for pre-approval.  Can they do this?  I am filing an appeal but want to know what other steps I should take.

[Amir Mostafaie]

Dear bmoffett,

Depending on your policy, they may be able to ask for it, but you will have to appeal it to make sure this is not due to a coding error by the hospital. There is a different code for emergency appendectomy than a routine appendectomy.

If this issue is not due to coding error, you will have to appeal your insurer’s decision based on reasonability grounds. How do they deem it reasonable to expect a patient who is medicated and/or in pain to contact them about getting authorization; especially if all of this happened outside their business hours?  

Sincerely,

Amir Mostafaie