Privacy violated or too sensitive?

[PennyLane 0]

I was a self-pay. I needed/wanted to do it this way for several reasons: (a) specific exclusion on the insurance, useless even trying (, the major reason, my medical privacy...basically I didn't want to leave a paper trail of having had the surgery for a variety of employment and insurance related issues. For the longest time, I refused to even show my insurance card at the surgeon's office.

Finally, they convinced me to allow them to bill the pre-op blood tests to the insurance co, saying that they'd never know the reason I had the tests and they're medically useful for reasons other than this surgery anyway, so I did. A few weeks later, I wrote out the hugest check of my life and pre-paid for the surgery.

Imagine my surprise, when, 2 months later (one week post surgery) I get a letter from my insurance company denying my claim to pay for the surgery.

WHAT THE HECK????

I can't even begin to express how upset I am. First off, while I know the hospital and program are reputable etc, it does seem a bit fishy that they took my money AND made an insurance claim (I know it was not intentional because they are not criminals but STILL, what a mistake to make). But really, I feel like my privacy has been seriously violated.

I have individual health insurance. They have already tried to kick me off because those blood tests I mentioned? I think they looked up the name of the surgeon, saw he did bariatrics and made up some bogus reason to cancel me (I caught them at it and made them reinstate me). Now that they know I had the surgery, I'm afraid they'll do it again. Other insurance companies will know, too. They share information like this. My dream job comes along with the need for a worldwide availability medical clearance--I was hoping to get it 5 years down the line when I can answer the "no major surgeries in the past 5 years" question with a "no" and since those forms don't specifically ask about Lap Bands just kind of not mention it, and now if they want to (I think) they can look into my insurance history and see all about it!

But beyond all of these reasons, I really do feel....violated. There's no other way to say it. I didn't even want to TELL them I had insurance let alone have them bill my company without my permission! I don't know what to do or how to fix this and I'm SO upset. What should I do?

Thanks for reading.

[SuzanneG 1]

PennyLane, I am so sorry this happened to you. I can't imagine what I would do in your shoes. You have every right to be upset and it does sound fishy. It's a crying shame that insurance is such a darn racket, especially car and health insurance.

I don't know what you can do at this point, but wanted to at least offer you some moral support. {{{{{{{{{Hugs}}}}}}}}}}}}

[MissMaryAnn 0]

If I were you I would contact an attorney for a (free) consult, and then the ombudsman of the hospital or clinic where you had the surgery, if only to understand what the implications of this information being available to insurers are. I mean, I'm not suggesting you sue, but I think you are within your rights to find out if the surgeon's office is in error, and if so, what rememdies are available to you-- such as reporting the surgeon to the licensing board, etc.

[SalOdyssey 441]

I would be super pissed off if I were you. Especially of going through the trouble of keeping it quiet. I would definitely seek a lawyers opinion. Never know maybe surgery will be free after suit. I think you have a cause for breach of privacy. Good luck and keep us posted! ! !

Sal

[Donna113 2]

I was self-pay also because my insurance had a specific exclusion on WLS so there was no point in even trying. However, based on the forms I signed pre-op, I'm pretty sure there were provisions in there about being able to share the information with my insurance company if they needed to for any reason so you should get a copy of all the documents you signed and peruse them thoroughly before going through the expense/bother of hiring an attorney.

[three sixty six 1]

Wow, that's really incredible. I'm sorry you're going through this! I agree with Di. Check your paperwork - they may have had you sign away your right, allowing them to contact your insurance company for more than just bloodwork.. it may be a blanket authorization. Or, maybe they just goofed. Either way, it sucks that it's already out there. I would definitely contact an attorney to ensure that your right to insurance is protected. Good luck - please keep us posted.

[di1138 8]

you might try Obesitylaw.com. What they did was 100% wrong! Good luck.

[Brandy~ 2]

They were definetly not within policy to act in this manner. I would first start with a formal letter (registered mail with sig) requesting reasons for their actions. Once I had that I would probably speak to an attorney.