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Old 04-30-2009, 04:06 PM   #1
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Pttd Surgery Insurance Headaches!

Hi To All
I had surgery Nov 20th '08, (calcaneus osteotomy, tendon transfer, bone graft, etc.) which was approved by my insurance company in Oct. '08. I thought my insurance compnay was paying which they did but than requested a refund from the hospital, anesthesiologist, doctor because they denied the claim. Insurance company comment: we do not cover weak, strained, or unstable feet. Of course I am fighting and it sounds like they are going to end up paying because it was approved but my worry is what about my other foot?! Anyone else have problem with insurance?

 
Old 04-30-2009, 04:10 PM   #2
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Re: Pttd Surgery Insurance Headaches!

wow. I have never heard of this. scary. I was sent a questionnaire asking if it was an accident and I answered that I was unsure what caused the problem. I have Blue Cross. What insurance company do you have?

emmie

 
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Old 04-30-2009, 05:27 PM   #3
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Re: Pttd Surgery Insurance Headaches!

I also received that questionnaire from my insurance company and said it was not an accident that I didn't know what caused it. My insurance is ___, usually they are good I just think the right hand doesn't know what the left hand is doing?

Last edited by marybn; 05-02-2009 at 08:28 PM.

 
Old 04-30-2009, 06:05 PM   #4
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Re: Pttd Surgery Insurance Headaches!

I am sorry that you are having this issue. It makes me sick and now scared it could happen to me. With everything we go through with the surgery and the pain we live with before, during and after the surgery, then we have to take on the insurance company? GRRRRRR!

 
Old 04-30-2009, 06:08 PM   #5
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Re: Pttd Surgery Insurance Headaches!

The questionnaire is very common. Whenever a patient runs up expenses beyond a certain threshold, the health insurer's legal people send out a questionnaire just to make sure there isn't some third party they can sue to recover the cost of treatment. It's called subrogation, they sue on your behalf with or without your permission.

Now, paying for a procedure and then trying to un-pay, that's pretty weird. I don't think I've ever heard of that, unless the insurance company had reason to suspect fraud or something.

 
Old 05-01-2009, 05:47 AM   #6
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Re: Pttd Surgery Insurance Headaches!

I don't think that thought it was fraud. I had been to no less than three ortho's in the last four years trying every other options, getting other opinions before surgery. If they researched I would think they could see surgery was my last resort. Who knows what insurance companies thinks?
I didn't mean to getting anyone worrying, I just had to vent and wanted to know if anyone had issues with their companies.

 
Old 05-01-2009, 08:31 PM   #7
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Re: Pttd Surgery Insurance Headaches!

This is truly frightening! I hope it all gets resolved soon for you Marybn, this is just one stress you don't need. I would try to find out now about the second foot so if/when you need that done, it's all set.

I just got a statement from the hospital the other day saying what my surgery cost - this is not including the doctor fee for the surgery - and it was near 70K. Yikes! I can't figure out why it's so high, possibly because California has super high malpractice insurance. I can't imagine what someone would do without any insurance and having this injury.

 
Old 05-02-2009, 05:19 AM   #8
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Re: Pttd Surgery Insurance Headaches!

I know, right? I can see how people go bankrupt from medical expenses. I do plan on getting my other foot done in October, we can't decide if we should get that set up now or get things settled and than set it up, any suggestions?

Last edited by marybn; 05-02-2009 at 05:20 AM.

 
Old 05-02-2009, 04:36 PM   #9
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Re: Pttd Surgery Insurance Headaches!

i am having insurance problems now too. i had great bc bs and had a wonderful job but when i went to my HR with papers telling them i was having surgery. 2 weeks b4 my surgery they fired me. i was at that job 5 years and worked hard. they had to do lay offs and i was one that got it. so my ins. paid for the visit b4 my surgery but not the surgery. now i am stuck with a 2,300 bill. I signed up for the cobra and indv. blue but it will not cover my surgery.
The company i worked for has been in the news so much this year over problems from bringing over seas help to work for them. then they lay off the American people that have put in 5 years or more. they just do not want to pay us right. needless to say i will be suing Cinram.

 
Old 05-02-2009, 09:01 PM   #10
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Re: Pttd Surgery Insurance Headaches!

If you are laid off, CarlaSt, they have to offer COBRA. It's the law.

 
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