I'm being billed for over $5,000 for a broken hand surgery, ANY ADVICE?

[jbot]

should have gone to mexico and get the surgery. afterwards, u could have partied like a king.

[enayes]

Here's what has happened so far:

Insurance company told my mom over the phone that my surgery would be covered. I proceeded with the surgery, presenting my insurance card at the hospital for the pre-op and the operation. No questions asked.

A few weeks after my surgery we start getting bills. One from the emergency room I first went to initially, and another from the hospital for over $5000, the original bill was over $8000, it showed that only $3000 was covered by my insurance.

Are they allowed to say something is covered if only part of it is?

So after we get the biils, my mom calls the insurance company. They tell her that the surgery was "out of network" and it's not covered. She flips out saying she called beforehand to make sure it WAS covered. They then tell her that it was a mistake and that they will take care of it. They give her a confirmation number, which she wrote down and has lost.

Bills kept coming, she called back, they told her that we have to appeal the claim. So we took all the bills, printed out some statements and mailed them to the insurance company. That was about 6 weeks ago. We haven't heard anything about the appeal and the bills continue to come threatening to hurt my credit, etc.

I'm very much looking forward to adulthood. Can't wait to deal with this sh!t on my own.

[DeuceWallaces]

Sounds like you guys are fukt, unless they report your confirmation number for you.

[tontoz]

Here's what has happened so far:


So after we get the biils, my mom calls the insurance company. They tell her that the surgery was "out of network" and it's not covered. She flips out saying she called beforehand to make sure it WAS covered. They then tell her that it was a mistake and that they will take care of it. They give her a confirmation number, which she wrote down and has lost.

Your mom may have really fuked up. First of all whether or not a procedure is covered and whether or not it is in/out of network are two completely separate issues. Calling to see if a procedure is covered doesn't mean it is in network.

There should be a list of network providers in your area in writing somewhere or online. That is something that you (or in this case your mom) should be looking up on your own. You shouldn't rely on a customer service rep for that.

And then losing a confirmation number......

If it is true that you had surgery out of network you could be screwed.

[bagelred]

Here's what has happened so far:

Insurance company told my mom over the phone that my surgery would be covered. I proceeded with the surgery, presenting my insurance card at the hospital for the pre-op and the operation. No questions asked.

A few weeks after my surgery we start getting bills. One from the emergency room I first went to initially, and another from the hospital for over $5000, the original bill was over $8000, it showed that only $3000 was covered by my insurance.

Are they allowed to say something is covered if only part of it is?

So after we get the biils, my mom calls the insurance company. They tell her that the surgery was "out of network" and it's not covered. She flips out saying she called beforehand to make sure it WAS covered. They then tell her that it was a mistake and that they will take care of it. They give her a confirmation number, which she wrote down and has lost.

Bills kept coming, she called back, they told her that we have to appeal the claim. So we took all the bills, printed out some statements and mailed them to the insurance company. That was about 6 weeks ago. We haven't heard anything about the appeal and the bills continue to come threatening to hurt my credit, etc.

I'm very much looking forward to adulthood. Can't wait to deal with this sh!t on my own.

So they have no record of any confirmation number on file ? Do they have a record of your initial phone call?

Don't worry yet....just take one step at a time. Whatever you do, do not pay anything at all YET. Don't worry about the hospital's threats. Ask the hospital accounting dept. for more time to deal with your insurance company as you are having a dispute.

It would really help if you had any record of who you spoke to, confirmation number, date you were told it was covered, any other specifics, etc.

[shadow]

keep at it with your insurance company. As a last resort if it doesn't work just call the hospital and tell them you can't pay the 5 grand and if they are willing to work out a deal. Typically they'll knock it down and break it into installments. Again this is a last resort. For now keep at it with your insruance company. Best of luck.

[monkeypox]

Hand surgery is one of the most difficult ones for a doctor to do. In fact in med school they tell you the success rate for most of the major ones is 50/50. So it's freaking expensive and may do more harm than good. Yeah, medicine isn't quite as advanced as people would like to think.

We've gone through this dance a bunch of times already with my family. You can keep fighting it, but really they're the ones that are experts at this. I'm guessing the 5000 bill might be the physicians bill that your insurance doesn't cover. As they run you around they'll threaten your credit and basically extort the money out of you. If it does go to collection, they will call you literally 40 times a day and basically be a jerk to you on top of that. You might have to contact your attorney generals office to get them to stop calling you at all hours. In the meantime your credit will get dinged. Most of them we just gave in and paid because of the credit threat and the previous experience with a collection agency.

The fact that you called apparently doesn't mean dick. I had a friend call and get confirmation that a procedure was going to be like 400 bucks. Two weeks after it's done he gets a huge bill. He calls his insurance company and they basically say "oops, they shouldn't have said that, we actually only cover a negotiated 10% of the fee." They have a record of who he talked to... but too bad this guy doesn't work there anymore. Nothing is in writing so too bad sucker. The kicker is that if he just went to the doctor and did it as a cash patient, it would have only been about $600 because that's what they charge cash patients because they're usually poor. When the insurance company come's a knocking, the procedure costs $1200, 10% of which is 120, leaving him with a nice 1080 bill. Nice.

For us, the ones we did win we basically stayed on the phone and would just keep asking for someone higher who would do something about it right then and there, or to at least explain why this wasn't covered. Just being a jerk on the phone and not taking no for an answer or not accepting another phone number you have to call and restart your whole explanation. This crap is so horrible. Seriously, it's almost better to just pour windex over your wounds and hope it gets better, at least you don't have to deal with this BS.

[bagelred]

Hand surgery is one of the most difficult ones for a doctor to do. In fact in med school they tell you the success rate for most of the major ones is 50/50. So it's freaking expensive and may do more harm than good. Yeah, medicine isn't quite as advanced as people would like to think.

We've gone through this dance a bunch of times already with my family. You can keep fighting it, but really they're the ones that are experts at this. I'm guessing the 5000 bill might be the physicians bill that your insurance doesn't cover. As they run you around they'll threaten your credit and basically extort the money out of you. If it does go to collection, they will call you literally 40 times a day and basically be a jerk to you on top of that. You might have to contact your attorney generals office to get them to stop calling you at all hours. In the meantime your credit will get dinged. Most of them we just gave in and paid because of the credit threat and the previous experience with a collection agency.

The fact that you called apparently doesn't mean dick. I had a friend call and get confirmation that a procedure was going to be like 400 bucks. Two weeks after it's done he gets a huge bill. He calls his insurance company and they basically say "oops, they shouldn't have said that, we actually only cover a negotiated 10% of the fee." They have a record of who he talked to... but too bad this guy doesn't work there anymore. Nothing is in writing so too bad sucker. The kicker is that if he just went to the doctor and did it as a cash patient, it would have only been about $600 because that's what they charge cash patients because they're usually poor. When the insurance company come's a knocking, the procedure costs $1200, 10% of which is 120, leaving him with a nice 1080 bill. Nice.

For us, the ones we did win we basically stayed on the phone and would just keep asking for someone higher who would do something about it right then and there, or to at least explain why this wasn't covered. Just being a jerk on the phone and not taking no for an answer or not accepting another phone number you have to call and restart your whole explanation. This crap is so horrible. Seriously, it's almost better to just pour windex over your wounds and hope it gets better, at least you don't have to deal with this BS.

Isn't the American system of medical insurance fun? So much more interesting than just having complete coverage by our gov't. That "European" system is just so BORING.

[bagelred]

keep at it with your insurance company. As a last resort if it doesn't work just call the hospital and tell them you can't pay the 5 grand and if they are willing to work out a deal. Typically they'll knock it down and break it into installments. Again this is a last resort. For now keep at it with your insruance company. Best of luck.

Yup. The last step will be negotiation with the hospital. But again, just wait it out at much as you can for now.

[the GIBBET]

Isn't the American system of medical insurance fun? So much more interesting than just having complete coverage by our gov't. That "European" system is just so BORING.

How come you only ever complain about rich people who aren't paying for this program or that program?

I never hear you complain much about unplanned pregnancy, dropout rates, poor parenting, crime epidemics, financial irresponsibility, etc. You know, the ways that many people who aren't rich contribute negatively to society.

All you are ever upset about is "corporate white republicans" who don't want to pay all their money for countless programs that you think should be "free" because you're not that one that has to pay. Maybe there would be more money for subsidized healthcare if the courts and prisons weren't packed and women weren't having 4 and 5 kids without being able to support them, thus not only requiring government financial assistance, but putting more and more kids into public schooling which also costs money. While you're gazing like a retard across the pond over at europe, why don't you look into how big THEIR problems are with those issues compared to ours. *******.

Why aren't you EVER complaining about individual values and responsibility? Because you're a f[COLOR="Black"]u[/COLOR]cking crybaby ass retard who thinks its the responsibility of a small few to work hard and fly right while everyone else just parties? F[COLOR="Black"]u[/COLOR]cking nimrod.


And it's great how you're like "oh, our system is so stupid, we need to do it like in europe." It's not as if you know the FIRST DAMN THING about how implementing ANY kind of healthcare system works. You're just spouting out ideology with no actual ability to support or explain it. You're a damn fool, but I aint mister t, I got no pity for you, *******.

[Colin Cowherd]

starface is so cute when he's angry

[the GIBBET]

starface is so cute when he's angry

Thanks, josh. Or Jefferson money. Whichever one of you it is this time.

[Colin Cowherd]

Thanks, josh. Or Jefferson money. Whichever one of you it is this time.

I can't help that that I'm a social outcast and have no friends, ok!?!?!

[Hawker]

Isn't the American system of medical insurance fun? So much more interesting than just having complete coverage by our gov't. That "European" system is just so BORING.

How bout a free market for healthcare? 67% is already paid for by the government...don't act like this is all caused by private companies.

[Meticode]

don't pay it.

Then it gets sent to a collection agency, then it hits your credit and you can't get it off for several years even after you pay it.