I had an operation done and the doctor's office told me they got authorization for it. But nobody told me the facility they did the operation in was out of network of my insurance, so now I'm going down for like 30k. Lovely. How is your day going?
EDIT: Looks like I will only have to pay like 2k according to the lady at the hospital
Signed, million man.
BETTER THAN YOURS...THAT REALLY SUCKS,MAN.
shareI know we sometimes have longer wait periods here, but I'm so glad I'll never be on the hook for 30k.
I'm so sorry this is happening to you. Is there anyway you can fight it, or even go after your doctor's office for telling you they had authorization?
I don't know. Everything I heard or read so far is telling me I'm screwed. I will know more tomorrow when I go to the doctor office and the hospital in person.
Signed, million man
I wish you the best of luck.
shareThanks. I'll post any updates.
Signed, million man
See if you're covered under this legislation against surprise medical billing:
"The No Surprises Act protects people from unexpected medical bills"
https://www.cms.gov/medical-bill-rights
It was non emergency. I thought the doctors office made sure that I would be covered at the facility. Apparently they didn't.
Signed, million man
The law covers non emergency.
You need to read what you signed so get a copy and speak to someone in government who could answer your questions if there's a problem. Check out the link carefully.
You need to contact an attorney.
shareYES!...THAT^
shareOr even the local tv news station. Maybe shining a spotlight on their unethical practices will get some results.
shareI mean somebody really messed up here and I'm starting to think it was me, but I had no idea that if the doctor got approval that the facility is still in question.
Signed, million man
Still, someone at that place should have went over the cost and options with you.
shareThey had me check in on a tablet and most of the lettering was small so I couldn't really read anything. All of a sudden a page popped up with payment of 1800 dollars. I thought that was the deductible so I payed it. But now I see on the insurance website that everything at that facility is being denied. Which is like 20k. Then there's others like the anesthesia person and so forth. Everything adds up to about 30k. If I had known this ahead of time I would have gone somewhere else in network.
Signed, million man.
Yeah, I'm royally pissed and they will not be happy to see me tomorrow. First thing in the morning.
Signed, million man
"no idea that if the doctor got approval that the facility is still in question."
That happened to my coworker. It's not uncommon. Did the form you sign say that you agreed to receive out network treatment?
This is a fed government website with two phone numbers for a patient advocate and No Surprises Help Desk.
https://www.cms.gov/medical-bill-rights/know-your-rights/using-insurance#notice-and-consent-may-cause-surprise-bills
I definitely had that thought. First I'm going to see what can be done without that.
Signed, million man
This is the best advice.
Get a lawyer, this sounds like chicanery.
This 👆💯
shareFuck man, hope you get over this bump.
shareI'm sorry man that sucks. Health industry and insurance is such a fucking scam.
shareIt is! It's been such a racket and societal issue for so many years now.
I had to have double cataract surgery two winters ago. Because of my mistrust of that industry, I tried to do my homework prior to that by getting on my insurance company's website and contacting customer service. It didn't work. There was so much misleading, confusing information I had to deal with, especially when it came to my co-pays. After the surgeries, I was continually scheduled for follow-up checkups weeks after my eyes had healed. And during those checkups, which usually lasted 5-10 minutes at the most, I routinely had to sit in the waiting room for up to three hours. I finally got so fed up, I actually posted on this board that I felt I was just being milked for more insurance money. I cancelled the last appointment, got monthly statements from the insurance company for a while about charges that weren't covered, but never a bill about those charges from that clinic. It finally petered out to no more statements. Go figure!
Politicians all in bed with the insurance companies filling their pockets which is why we'll never have one option for all. The system is completely broken by greed and corruption.
I went to the ER a few years ago for abdominal pain. Pain was 5/10, nurse instantly offers me morphine lol, I'm like wtf no. Did CT scan and doc comes in and says everything is OK and could just be gas, if it gets worse then come back. End up leaving and get the CT scan results from the hospital app and read them in the car. The imaging tech diagnosis it as epiploic appendagitis. I get home and hospital calls and says that's what it is and take an anti-inflammatory. All turned out well. Got 5 different bills from the hospital and was charged for the same code twice because there was a shift change and I saw two different doctors during my visit, one when I arrived and then another who gave me the incorrect results. Additionally they charged me for the phone call of the results that they misread.
"Politicians all in bed with the insurance companies filling their pockets which is why we'll never have one option for all. The system is completely broken by greed and corruption."
Agreed! I once worked for a newspaper for a number of years. One day during a business meeting, the publisher suddenly announced that he was leaving in order to take a position as a liaison between the local health care system and the state government. He had seen the handwriting on the wall, knew that's where the money was. Some months after having finally left that job, I had a chance encounter with a favorite coworker from there who told me his wife had had an unexpected stroke, wound up in the hospital for a week, and he was being hammered with a bill of $250,000. I was stunned, speechless, could only shake my head. Like I said, he was a favorite coworker because he had a good, strong work ethic. He was the type of guy that was supplementing his income by mowing lawns during the spring and summer. I've often wondered how he finally dealt with that situation.
That sucks. I’m sorry that’s happening. Hopefully, you can get it worked out in the best possible way.
shareScammy.
Lawyer up Amigo and be sure to claim emotional damages such as depression.
Hurt them.
I'm going evidence gathering tomorrow
Signed, million man
Just go as a fact finding mission and make NO commitments and don't acknowledge you might have done something in error. Thank them when they're through and politely tell them now you will have to consult with your attorney with the information they have provided.
Best for you to talk as little as possible.