Jump to content
×
Are you looking for the BariatricPal Store? Go now!

Recommended Posts

After close to 23 months, payment is being made for my Tummy Tuck. Insurance gave pre-approval for abdominoplasty and panniculectomy in December 2010. After the procedure and hospital and surgeon submitted claims, the insurance denied them after giving pre-approval - CRAZY!. I have been battling this for over a year and finally today I received a letter from the insurance (case specialist) that they are making it a priority to have this resolved and payment sent out immediately.

I'm relieved to say the least, as I don't have over $12,000 lying around that I could pay for this myself and can't afford to take a hit re: credit w/having them submit this to some debt collector. I am so very happy that stayed in constant contact with the hosptial finance representative (who kept this from going into collections) and the fact that I didn't give in and crawl in a hole re: insurance. My last letter with all supporting documents was to the Department of Insurance, their office contacted me w/n days to inform me that they received my letter and had started the investigation.

Mind you, I had written letters to the insurance repeatedly (all went unanswered) until my last letter (directed to the dept of insurance and cc'd to BCBS, BBB and the finance office of the hospital that the surgery took place) I previously received no replies. Finally, I can place this madness behind me.

I felt like I was between a rock and a hard place, as I was unable to get fill under flora (sp?) because of this lingering balance with the hospital.

I'm so very excited. If anyone has had this experience, don't cave... reach out to officials who monitor these businesses.

I'm finally, on the road to enjoying the new me.

Share this post


Link to post
Share on other sites

Congratulations!

Share this post


Link to post
Share on other sites

*Applause* Good for you for sticking with it, when what the insurance company wanted you to do was just give up and pay.

Share this post


Link to post
Share on other sites

That must be such a weight of your shoulders!

Share this post


Link to post
Share on other sites

Ladies, I can't begin to express the relief I felt. JOY!!!! that this nightmare has come to an end. I finally, called my PS after over a year (as I felt shamed...) to have him take a look at his work, it looks GREAT, however, I still have a dog ear that he was working on that hasn't gone away.

Yes, I'm sure the insurance was waiting for me to give up or have the 2 yr mark hit and tell me it's too late.

Now, I can focus on losing these last blasted 10lbs.

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now

  • Trending Products

  • Trending Topics

  • Recent Status Updates

    • BeanitoDiego

      Oh yeah, something I wanted to rant about, a billing dispute that cropped up 3 months ago.
      Surgery was in August of 2023. A bill shows up for over $7,000 in January. WTF? I asks myself. I know that I jumped through all of the insurance hoops and verified this and triple checked that, as did the surgeon's office. All was set, and I paid all of the known costs before surgery.
      A looong story short, is that an assistant surgeon that was in the process of accepting money from my insurance company touched me while I was under anesthesia. That is what the bill was for. But hey, guess what? Some federal legislation was enacted last year to help patients out when they cannot consent to being touched by someone out of their insurance network. These types of bills fall under something called, "surprise billing," and you don't have to put up with it.
      https://www.cms.gov/nosurprises
      I had to make a lot of phone calls to both the surgeon's office and the insurance company and explain my rights and what the maximum out of pocket costs were that I could be liable for. Also had to remind them that it isn't my place to be taking care of all of this and that I was going to escalate things if they could not play nice with one another.
      Quick ending is that I don't have to pay that $7,000+. Advocate, advocate, advocate for yourself no matter how long it takes and learn more about this law if you are ever hit with a surprise bill.
      · 0 replies
      1. This update has no replies.
    • BeanitoDiego

      Some days I feel like an infiltrator... I'm participating in society as a "thin" person. They have no idea that I haven't always been one of them! 🤣
      · 0 replies
      1. This update has no replies.
    • ChunkCat

      Thank you everyone for your well wishes! I totally forgot I wrote an update here... I'm one week post op today. I gained 15 lbs in water weight overnight because they had to give me tons of fluids to bring my BP up after surgery! I stayed one night in the hospital. Everything has been fine except I seem to have picked up a bug while I was there and I've been running a low grade fever, coughing, and a sore throat. So I've been hydrating well and sleeping a ton. So far the Covid tests are negative.
      I haven't been able to advance my diet past purees. Everything I eat other than tofu makes me choke and feels like trying to swallow rocks. They warned me it would get worse before it gets better, so lets hope this is all normal. I have my follow up on Monday so we'll see. Living on shakes and soup again is not fun. I had enough of them the first time!! LOL 
      · 0 replies
      1. This update has no replies.
    • BeanitoDiego

      Still purging all of the larger clothing. This morning, a shirt that I ADORED wearing ended up on top. Hard to let it go, but it was also hard to let go of those habits that also no longer serve my highest good. Onward and upward!
      · 0 replies
      1. This update has no replies.
    • Onedayatatime365

      Looking to connect with others who are also on the journey of better health. Post-Op Gastric Sleeve (4/11/24).
      · 0 replies
      1. This update has no replies.
  • Recent Topics

  • Hot Products

  • Sign Up For
    Our Newsletter

    Follow us for the latest news
    and special product offers!
  • Together, we have lost...
      lbs

    PatchAid Vitamin Patches

    ×