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The Power Of The Pen!

Cherishthepast

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Cherishthepast    20

Cherishthepast
Posted

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.

DELETE THIS ACCOUNT! and kyrasgrandma reacted to this

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CHEZNOEL    4,061

CHEZNOEL
Posted

Congratulations!

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dk4k    15

dk4k
Posted

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

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joylene6    5

joylene6
Posted

That must be such a weight of your shoulders!

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Cherishthepast    20

Cherishthepast
Posted

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.

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Go To Topic Listing Plastic & Reconstructive Surgery

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    • Aunty Mamo

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    • BeanitoDiego

      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.
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