Insurance Woes

[Captain Deb]

There seem to be so many Newbies and newly treated AN ers on this site, that I just thought I'd share some stuff with y'all regarding my experience with my insurance company--getting the bills paid and all.  First of all, when the bills start rolling in--be sure to get ITEMIZED every thing before you pay anything--even if it means putting off paying them for a month or 2.  As my bills started coming in, my husband just paid them, no questions asked. Also scrutinize the statements from your insurance company.

My Insurance company, Blue Cross Blue Sheild, one of the best in the biz (supposedly) billed me at first for out-of-network after a lengthy pre-certification process, resulting in an extra $10,000 being added to my bill.  They also refused to pay for the internist for more than a 2 day hospital stay. (Come on, it's brain surgery,folks, not a tonsellectomy!)  I also did not get credit for the $3000 I forked over up front to the hospital.  Etc, etc, etc.

All in all, by going over every bill with a fine-toothed comb, which isn't easy post-surgery, I got over $5000 in refund checks from various docs and the hospital.  I ended up getting a great gal on the phone from the insurance company who seemed to be on my side and I kept in touch with her.  It took about 3-4 months to settle everything and about 20 phone calls.

Be persistant, ask questions and get those itemized bills and keep good records and you may recoop a few fun tickets to put toward that cruise!

Good Luck to all Newbies and Pre-treats!
Captain Deb

[Battyp]

I never did figure out how come they told me 1K out of pocket and I was charged more than that.  They never did explain it to me.

[Gennysmom]

I think this will be one of the few bonuses for me being with an HMO.  I feel lucky getting a good surgeon out of the deal, as that doesn't always happen.  With an HMO I don't even get bills.  I pay my co-pay at the time of use, and that be it.  Never had surgery, so it may be a bit different...I think there's a deductible, I need to check.  But all the other office visit/outpatitent kind of things...nada.

[Static]

I had PPO so I did have to pay for doctor's visits (except post-op required visits, they were paid for in full) and I didn't get any doctor/i.e. hospital bills except copies showing what the insurance co was charged and what they actually paid the hospital.  It's less than half of what someone without any insurance would have paid which stinks because someone with no insurance needs the break more, don't ya think?  I'm glad I did have the insurance though.  Oh wait, I was told that the walker they gave me would be covered by my insurance but it wasn't, but that's it.  I'd have to pull the copies to remember exactly what it all cost (had  I not had insurance) but I do remember it was huge!

[Captain Deb]

After I met my deductable, I had another little bug-a-boo called "out-of-pocket" before the insurance kicked in and started paying 100%.  I was not given "credit" at first for a bunch of things until I started squawking about them!
Capt Deb