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Old 01-14-2005, 12:10 PM   #1
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time sensitive...any help please?

We are trying anything and everything and am now posting in the hopes that someone out there can help.

My brother is 42 and has been diagnosed with rare bile duct cancer. He was scheduled for surgery yesterday in Chicago. On 12:00 p.m. Tuesday my sister in law checked with the surgeon's office to confirm everything was fine with their insurance and was told that it was, no problems. By 3:00 p.m. that same day they received a phone call saying, basically, that the insurance company was investigating and, because of that, the surgeon decided to give his time spot to a different patient. They said it was the "surgeon's call" because of his fee and bumped his surgery to anywhere between 2 weeks to 2 months. In the meantime he has 2 stints in his bile ducts that can collapse at anytime. Wouldn't you know, it's all about the fee the surgeon is going to collect.

My sister in law has spent the last 24 hours faxing authorizations and trying to follow up with the insurance company, but of course no one is any hurry to get anything done. All the while now, by brother can't keep anything down, is vomiting and only hoping something can be done before it becomes an emergency.

My sister in law also called the Cancer Society and they were appalled that it all came down to a fee. They suggested she call the state insurance commission.

In the last couple hours we are now calling our state representatives and the insurance commission for the state of Illinois.

If anyone has any suggestions or have been through a similar situation, please let me know what you did or what you think may help.

 
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Old 01-14-2005, 01:02 PM   #2
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Re: time sensitive...any help please?

It is mostly the responsibility of the doctors to communicate the urgency of the problem to the insurance company. Put pressure on the doctors.

I am moving this post to the Health Insurance Issues Board.
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