xp - Post-op insurance problems
Has anyone been pre-approved, had the surgery and then had a hard time getting insurance to pay the bill???
I had surgery 9/22 and was pre-approved with United Health Care. I got a call from my surgeons office this week that they haven't been paid yet (4+ mos) and that I need to do something about it or I will get the bill (over $40,000)! I call UHC and am told that it has been forwarded to "rapid resolution" and they have to process it. It will take 10-14 days. What???? You've had 4 months to process it!!! WTF???
Now I get daily calls from my surgeons office to see what I have done about this. Thursday the office manager calls and says "please hold for the doctor". Next thing I know I am getting a "friendly" lecture on needing to take care of this, the accountant is hounding him to get payment, that I will get the bill, etc. etc. Double WTF!?!?! I am not stupid, I don't need the doctor telling me what to do and trying to guilt me into something. I was pleasant enoough on the phone, but I wanted to SCREAM...F*CK U...I am not some stupid child who needs a talking to by a doctor. I'm a f*cking lawyer and don't need to be treated like a moron!
So after that I am PISSED!!! So, I call UHC AGAIN and now threaten filing a complaint with the Dept of Labor. Suddenly my claim is being sent to a different department - complex claims - and that I will get a call back on Tuesday.
I ask to speak to supervisors every time and I am told no.
I called the Dept of Labor on Thrusday and filed a phone complaint. They told me they can't really do anything until UHC denies the claim.
The kicker...every other bill associated with the surgery was paid months ago....the hospital, the radiologist, the anesthesiologist, labs, etc. The only unpaid bill is the surgeon.
So...........................................has anyone else experienced this? Any recommendations? Advice? Any and all good juju would sure help! (Can't hurt).
P.S. The insurance is self-funded by the company, so it falls under federal ERISA law, not state insurance departments.
I had surgery 9/22 and was pre-approved with United Health Care. I got a call from my surgeons office this week that they haven't been paid yet (4+ mos) and that I need to do something about it or I will get the bill (over $40,000)! I call UHC and am told that it has been forwarded to "rapid resolution" and they have to process it. It will take 10-14 days. What???? You've had 4 months to process it!!! WTF???
Now I get daily calls from my surgeons office to see what I have done about this. Thursday the office manager calls and says "please hold for the doctor". Next thing I know I am getting a "friendly" lecture on needing to take care of this, the accountant is hounding him to get payment, that I will get the bill, etc. etc. Double WTF!?!?! I am not stupid, I don't need the doctor telling me what to do and trying to guilt me into something. I was pleasant enoough on the phone, but I wanted to SCREAM...F*CK U...I am not some stupid child who needs a talking to by a doctor. I'm a f*cking lawyer and don't need to be treated like a moron!
So after that I am PISSED!!! So, I call UHC AGAIN and now threaten filing a complaint with the Dept of Labor. Suddenly my claim is being sent to a different department - complex claims - and that I will get a call back on Tuesday.
I ask to speak to supervisors every time and I am told no.
I called the Dept of Labor on Thrusday and filed a phone complaint. They told me they can't really do anything until UHC denies the claim.
The kicker...every other bill associated with the surgery was paid months ago....the hospital, the radiologist, the anesthesiologist, labs, etc. The only unpaid bill is the surgeon.
So...........................................has anyone else experienced this? Any recommendations? Advice? Any and all good juju would sure help! (Can't hurt).
P.S. The insurance is self-funded by the company, so it falls under federal ERISA law, not state insurance departments.
day of surgery - 296 current goal - 195 highest ('98) - est'd 320
Joyce, Try to find out what code the docter used when he submitted the claim. Also make sure he had been precertified. Make sure he has the right insurance co, and that they have your name spelled right. Also, make sure his office did not take a zero in your account number for a O.
I hope these sugestions help.
Lisa
I hope these sugestions help.
Lisa
Most Active
Recent Topics
