Originally Posted by
jessmarimba
Whew. Well, the insurance and the physician's network are reviewing the costs. The insurance says the physicians were out-of-network, but will be re-reviewed for an in-network rate because it was emergency care. The physician's network says that they are in-network. Either way...my fingers are crossed.
I think the physicians were people who were consulted prior to surgery (to decide to call in my surgeon) and after surgery (since my surgeon only works on emergency trauma cases and isn't regularly at the hospital). Just a guess though.
And wow - thanks for the article - my "itemized" bill from the hospital has a "pharmacy/supplies" (yes, that's as itemized as it got) cost of over $72,000 (!!!!). I guess the insurance wasn't too particular and just paid all of that, but it is really and truly insane. I should've gotten to keep the hospital bed for that price
I've had several experiences with insurance companies where they initially didn't want to pay for service but after I contacted them they revised things and increased what they paid. In 1993 after I had ankle surgery, I had to send them a copy of the surgeon's operative report, and then they covered everything at 100%.
More recently with the dentist, I had a filling that needed to be replaced and due to the size of the filling and the fact that the tooth was a molar that did lots of heavy-duty chewing, the dentist replaced it with an implant instead of a regular filling. At first the insurance company refused to pay for the implant, so I called them and said I wanted to appeal. I explained the reason for the implant over the phone and based only on what I said, they reconsidered and paid for the implant. I later learned that the dentist's office had included documentation with all the same information when they initially filed the claim on my behalf. I think the insurance companies figure they should deny things at first and see if anyone will make the effort to appeal.
So, hopefully you will have the same experience and they will cover those doctors' costs now that you've contacted them.
BTW, I was still getting bills for that ankle surgery more than a year afterwards. The major bills came pretty quickly, but bills for little things like the crutches I got from the hospital trickled in very slowly. Also I was frustrated by multiple bills for things like radiology and testing -- first I'd get the bill for the x-ray or MRI or lab, then a couple of weeks later I'd get a separate bill for the person who read the results. I hope things are more streamlined for you. Most importantly, I hope you heal well!
- Gray 2010 carbon WSD road bike, Rivet Independence saddle
- Red hardtail 26" aluminum mountain bike, Bontrager Evoke WSD saddle
- Royal blue 2018 aluminum gravel bike, Rivet Pearl saddle
Gone but not forgotten:
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