I had a really easy surgery. Everything went much better expected...with the exception of one little hiccup:)

I had just gotten to my room, was talking to my husband, feeling really good.....when this extremely worried looking hospital administrator came in and asked me if I was feeling up to talking for a minute.

I felt great...so I was like...Of course..

And she asks me..."Are you in the process of having your surgery financed?"

And I go...."Uh, no. I have insurance."

And she goes...."I was just on the phone with your insurance company and apparently there's been some mistake. Your rider doesn't cover bariatric surgery."

I can't overemphasize how grim this woman looks. She knows she's giving me horrible news, and it's her job to protect the hospital financially....she looks like she feels terrible for me.

She's trying to be really gentle and says "We could do an 18 month financing plan. We don't usually do this and we're really not sure how this happened. Usually financing is in place."

And I go..."Um, can I show you something?"

I had my husband get my folder of stuff that I had sense enough to bring to the hospital with me. In it...was a copy of my approval letter from my insurance company.

So I give her the copy of the letter....and she looks baffled.

I go..."Will that help you?"

And she goes..."It just might. Please give me ten minutes. I'll be right back."

She comes back in ten minutes...all smiles. "I'm so sorry. You have the same name and birth date as another patient in the system and we were trying to bill the wrong person. You're all set. I really appreciate you bringing this letter with you, it helped immensely. I'm really sorry about worrying you when you're already stressed."

And I'm like..."I feel so shockingly good, I'm just grateful the surgical team is top notch. No one's perfect. If mistakes are gonna happen, I'd rather they happen in billing, you know?"

She smiled, apologized again, and excused herself.

Later that day I got flowers from the hospital with a note from her thanking me for being understanding about the mix up.

Moral of the story: Bring a copy of your approval letter to the hospital with you.

Other Moral of the story: Give your kid a somewhat unique name. Mine is as generic as John Smith... and this has caused me issues a couple of times.

Edited January 23, 20188 yr by Creekimp13

So legally, if the insurance company sends you a letter of approval, they HAVE to pay and can't change their minds after the surgery has happened?

13 minutes ago, FluffyChix said:

So legally, if the insurance company sends you a letter of approval, they HAVE to pay and can't change their minds after the surgery has happened?

Read the post again. That's not what happened.

They billed another person who had my name and birthdate. Her insurance didn't cover the surgery. Mine does:) When they sent the right info in, it showed up as being pre-approved.

3 hours ago, abefroman329 said:

Read the post again. That's not what happened.

Thanks Abe Froman the Sausage King of Chicago. I totally "get" that wasn't what happened. I guess, I should have better communicated, cuz what I was hoping to get was reassurance that, "Oh yah, no problem! If the insurance company sends you a letter of confirmation they are legally responsible for coverage."

I understand that the hospital confused two people with the same name and billed the wrong person.

Good times!

That's a scare! I'm jealous that you were awake after surgery! I could not wake up. Except to dry heave!

I woke up super quick. I was alert and oriented in the recovery room for over an hour before they had my room ready. Sitting up, feeling pretty good, begging for ice chips. Man, your mouth gets dry!!

As soon as I got to my room, I was out of the bed using the bathroom and roaming the halls. Had half a dozen visitors that night and took a walk with all of them:)

I hope I'm just strong as you were post-surgery. This may sound silly but since I'm older than the average bear, as Yogi Bear would say. I want to prove to everyone I can handle anything they throw my way. Maybe it's vanity but that's how I am. Greatful my name isn't that generic, there's definitely only one like me.

Sent from my VS880PP using BariatricPal mobile app

19 hours ago, FluffyChix said:

Thanks Abe Froman the Sausage King of Chicago. I totally "get" that wasn't what happened. I guess, I should have better communicated, cuz what I was hoping to get was reassurance that, "Oh yah, no problem! If the insurance company sends you a letter of confirmation they are legally responsible for coverage."

I understand that the hospital confused two people with the same name and billed the wrong person.

Good times!

Not sure a letter would constitute a guarantee of payment, but it would make for one heck of a lawsuit! My guess is it would go a long way towards either them paying or an amicable settlement of some kind. Always best to get a letter directly from the insurance company. Mine even offered a full break down of the charges and what I'd owe.