On January 12th I contacted a world-renowned Gamma Knife specialist and scheduled my Gamma Knife radiosurgery for February 2nd, with my pre-surgery appointment occurring the day prior on February 1st.
I also booked my hotel/lodging and travel plans.
I was told by a member of the surgeons office that "she had worked there for more than 15-years and could tell me immediately that my insurance would be accepted, and also that I would be "in network."
Awesome right?
On January 25th I received an email confirmation from the Gamma Knife surgeons office indicating that "everything was good to go with my insurance."
Fantastic! Everything is in place. What could possibly go wrong?
Well, as many of you know, the days just prior to surgery can be nerve wrecking for most of us.
Incredibly, just 4 days before my scheduled surgery I received a phone call from a "customer service representative" from the Gamma Knife surgeons hospital indicating that "my case was reviewed by board members and that they will not treat me unless I pre-pay $21,000 cash immediately before the surgery!"
Are you serious!
Obviously, my family and I have been in emotional turmoil over this, as it should have never happened in the first place, especially from a first-rate office. I immediately contacted my insurance company directly, and spent close to 3 hours on the phone with them. They indicated that I indeed was approved for the Gamma Knife treatment out of state.
To make a long story short, this hospital still refuses to treat me unless I pre-pay $21,000 cash for there special deal due before my surgery. The hospital is claiming just 4 days before my scheduled surgery that they "don't have a contract with my out-of-state insurance company," and that I would need to fork-over $21,000 cash (pre-paid) or my upcoming surgery would be canceled.
I have the best PPO insurance available in my state, from a national top-of-the-line insurance company.
The worst part was the hospital "customer service rep" was completely "robotic" and unapologetic (almost collections agency like). Furthermore, the world-renowned surgeons office told me they would contact me immediately in the morning to discuss this ordeal, but surprise-surprise they never even bothered to contact me again. Very disappointing from such a first-rate establishment.
I don't care if you're the best surgeon in the world, if your staff and hospital treat brain tumor patients this way it's completely unacceptable. With no apology offered.
For God sakes, I have a brain tumor and they're treating me like this less than 4 days before my scheduled surgery.
I still can't believe such a highly respected doctors office would do this. These people emailed me an "insurance confirmation" letter only to have their hospital staff cancel my appointment just 4 days prior to my surgery and tell me to "disregard" with no apology whatsoever
At the end of the day, I had to cancel all my travel plans and my hotel/lodging reservations, and I also had to cancel the surgery. Now I'm back to "square one" while my tumor is still growing. All this time has been wasted while I could have booked another facility.
Am I wrong to feel this upset after having been approved? Who do you think should be responsible for all the canceled airline fees and hotel fees, not-to-mention all the emotional distress this has undoubtedly caused me and my family?
What a waste of time and emotions.
How would you feel if this happened to you? Not even an apology. They could straight-up care less for what they put me and my family through with their "robotic" approach. It was surreal.
Anyways, now it's time to look for another treatment center. Apparently the lesson learned is, even if you have a "pre-approval" letter for the surgeons very own office claiming your insurance is "good to go", the hospital can still override the decision just days before your scheduled surgery and tell you to "disregard that approval letter" because their hospital doesn't have a contract with your insurance company and their doctor is "out-of-network."
The truth is I can still see "out-of-network" doctors with my PPO insurance; however, this hospital still refuses to treat me stating they don't have a contract with my insurance.
Then why did they send me an approval letter in the first place?? Frustration to the max!!
Most hospitals want to work with your insurance company and "win the business." Some hospitals even have insurance advocates who will do everything possible to make things work; however, obviously these people went out of there way to (unapologetically) deny me.
