So I think I was lied to...

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DivaDeuce007
Posts: 46
Joined: Wed Jun 01, 2011 5:03 pm

So I think I was lied to...

#1 Post by DivaDeuce007 »

So I am currently dealing with a fairly large issue. My surgeons office called me back in January to schedule Surgery I went in Feb 3rd which was about 2 weeks after i got the call to schedule stating my insurance "pre-approved" the procedure. Day of surgery there was this big to do.. because the surgeons office did not send my paper work to the hospital and the hospital wasnt going to let me go into the operating room. But they did after going back and forth with the surgeon.

So here is where it gets crazy.. and I know I was lied to.. I start receiving notices from my insurance stating they do not cover the procedure and basically would not be paying for it. THEN I start getting bills from the hospital and surgeons office saying the insurance never paid them and I owe them almost 50k! So I call the insurance company and they told me that they told my surgeons office on the phone and sent letters to them in January 7-10 days after my consult and days before my surgeons office called me and let them know that they would not be paying for anything as the procedure was not covered by my insurance.


Craziness!!

RMF7825
Posts: 67
Joined: Sat May 14, 2011 9:55 am

Re: So I think I was lied to...

#2 Post by RMF7825 »

If I were you, I would be asking for copies of everything. Remember you can always appeal any denial so there is hope.

DivaDeuce007
Posts: 46
Joined: Wed Jun 01, 2011 5:03 pm

Re: So I think I was lied to...

#3 Post by DivaDeuce007 »

Oh I am. My insurance is limited as I am an AmeriCorps volunteer so when the surgeons office said I was approved I was surprised. But all of this... Wasn't expected.

Rodney008
Posts: 90
Joined: Wed Jun 16, 2010 10:20 pm

Re: So I think I was lied to...

#4 Post by Rodney008 »

Looks like this is going to turn into a collection and or legal problem. Try handling it on your own but if it comes down to it hire a good civil attorney that specialized in insurance and healthcare. It will cost you a lot less than $50K. Good luck!

DivaDeuce007
Posts: 46
Joined: Wed Jun 01, 2011 5:03 pm

Re: So I think I was lied to...

#5 Post by DivaDeuce007 »

I'm trying to avoid this becoming a collection issue. I don't need that type of problem. But I do want answers as to why the surgeons office told me I could go a head and schedule surgery when they got the denial notices a week before they told me to come to schedule surgery :-/

class3underbiteboy
Posts: 25
Joined: Sat Apr 30, 2011 2:32 pm

Re: So I think I was lied to...

#6 Post by class3underbiteboy »

DivaDeuce007 wrote:I'm trying to avoid this becoming a collection issue. I don't need that type of problem. But I do want answers as to why the surgeons office told me I could go a head and schedule surgery when they got the denial notices a week before they told me to come to schedule surgery :-/
You probably won't find those answers here unless someone else had this exact problem (which I never heard of). What did your surgeon say?

DivaDeuce007
Posts: 46
Joined: Wed Jun 01, 2011 5:03 pm

Re: So I think I was lied to...

#7 Post by DivaDeuce007 »

He's currently out of the country so I haven't been able to speak eith him. I'm sure this is going to be a 14t type of thing but I figured I'd post it in case it has happened to anyone else or ends up happening

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