Treatment Insurance Payments

[ash]

I live in New Jersey and went to Stanford in California for CK. The insurance company has not paid all charges in full because there was some precertifications needed but were not obtained by Stanford and Stanford is now billing me for these shortages. The insurance company is reviewing it but they explained to me that when you go out of your local area, the facility does not know your insurance company's requirements. I recommend that you get a paper listing all treatments and submitt it to your insurance company for their approvals and requirements prior to treatments. Stanford was in network and I feel they have a responsibility at the minimum to advise me to check for insurance requirements.

[james e]

I was going to have surgery at HEI but this same issue came up, so rather than bet my retirement funds on a good outcome with insurance payouts, I stayed at home and spent my money here. Several good things came out of it. My doctor is in Texas, and I am in Texas. Any problems or follow up is needed, he is right down the street. My money stayed in Texas. My doctor is as good or maybe even better than any doctor at HEI. I had a great surgery and outcome.

I am glad you brought this up. The newbies need to check on this before they go out of their area. It could be a really big financial deal!

James

[millie]

I myself am waiting until Medicare kicks in for me October1 since the  AN doctors I like in NYC do not take Empire Blue Cross/Shield but they do take Medicare.  I never thought I had to worry about insurance but then I never had any health issues before-this is in the thirty years I carried the coverage.

[ash]

I sent a fax to three billing agents handling my three different bills from Stanford that Stanford should obsorb these charges since they did not obtain the precertifications nor informed me that they were needed. Lucky for me prior to treatments I contacted my insurance company and asked if I needed any precerts and they said no(but they were incorrect). With this being on record my insurance company paid two of the bills to Stanford and missed the third but are looking into it again. But I did receive a call from Stanford about the third bill and they said they changed the balance on the third bill to zero. I requested a statement stating this and they said they will send it to me. I also included in my fax that I want invoices from all bills stating zero.

[skipg]

Good report and shows the reason to follow the appeal process and keep records. Congratulations on the zero balance.
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