Cleveland Clinic didn't get a pre approval for my nerve block

[Mei Mei]

and now I have not only a $450+ bill but also a $10,000 bill for the   ER and the in patient ICU.   I worte a letter to the Cleveland Clinic President and they got the Ombudsman to respond.   She contacted the doctor who gave the injections that made me pass out and he wanted to talk with me.on a conference call.   I didn't see any point in that.   I just want the papers to be filed properly.   My insurance card says $50.   He said "I didn't know you didn't have bone in your skull and I injected directly into your brain and you passed out and your eyes dilated.   We intubated you and put you on oxygen.   Then we transferred you to the Emergency room.   

So now because they didn't pre approve the Occipital Nerve Block, I'm not only stuck with the nerve block bill but the ER bill, the CT scan bill and the ICU bill.

Any suggestions?   I told them in the letter that I wasn't going to sue anybody but I want the bill to be handled properly.  The ombudsman understood that I didn't need to talk to the doctor but did I want a letter from the doctor.  I said no.   I want a letter from the President to whom I wrote a letter to.   She said he is never going to see my letter but she would write to me.

I guess if United Healthcare denies payment, I will have no choice but to go to a lawyer.   I didn't want to do that.

Thanks to all of you for listening!
MM

[Jim Scott]

Mei Mei ~

I'm so sorry to learn about your hassles with your medical insurance carrier and the doctor that, in my non-professional opinion, made an error that necessitated all the medical services you then required.  That he is now pleading ignorance and, in essence, blaming you for the screw-up, is outrageous.  My suggestion - before seeing an attorney - is to contact your state insurance commission office to see if they can possibly intervene.  http://www.mdinsurance.state.md.us/sa/jsp/Mia.jsp.  If that doesn't help, you know what to do next - but, like you,  I hope you don't have to.

Jim

[Mei Mei]

Thank you as always, Jim.   It's Friday, but I will make the contacts on Monday morning.   There's so much to deal with in the follow up of my surgery.    Wish all were simple but that is not always the case.   Hope I don't have to see a lawyer as you know that wasn't what I was after...just healing.

Thanks again!
Mei Mei

[leapyrtwins]

Mei Mei -

I'm sorry to hear about this, but the first rule of any medical procedure (and not just those with the potential of being very costly) is to check with your insurance company to see if you need to be pre-approved.

Even if you are 100% certain that you don't need to be pre-approved, call your insurance company anyway and double check.

I know a lot of people who have had this same issue and unfortunately there's not a whole lot you can do about it - lots of times, even with a lawyer.

Hope everything turns out okay for you,

Jan

[Mei Mei]

Thanks, Jan.   The nurse before the injections came in and said she got a pre approval so the Ombudsman is tracking it down and they've sent some papers that UHC is asking for.
The Emergency Room and overnight stay was as a result of my passing out and stopping breathing for 5 hours after the injection and being put on life support.   He injected directly into my brain and not into the skull.

Take care and see you in Cinncinati!

Mei Mei

[leapyrtwins]

Unfortunately chances are very slim you'll see me in Cincinnati.

As much as I'd love to attend the symposium, my finances just won't let me.

Am hopeful I'll make it in 2013.

Have a great time!

Jan

[Mei Mei]

Well, now I have a two page denial letter from a doctor at United Healthcare.    Will go through the link that you gave me.     It's very upsetteing because the nurse said it was authorized.   Now I have this $10,000 + bill to deal with.   The shots in Maryland and DC were approved but why not in Cleveland.

Mei Mei