Insurance info you may be shocked by
Most of you know me and my Mom. Both of us have had the RNY, Mom's was over 2 years ago. The other day Mom got a letter in the mail saying she was going to be billed for her surgery. Now this is after they already paid for it, they said the surgery happened too late after the aproved date or something like that. We are all hoping that this is just a mistake and that they will be able to straighten it all out. So I talked to a friend that deals with insurance companies everyday at a Dr. office and she had some shocking knews I thought I would share. Insurance companies have 7 years to reveiw and audit a medical claim and if they feel that a surgery was approved and performed and feel later that it was not a medical neccessity they can reverse their decision and bill you for the money! I think that this is a crapy law, they know your medical history before they approve and I feel once they pay for it, it should be a done deal. If they feel that you didn't need it well oh well that is on them. What do you think? I hope I am not the only person to fell this way!!
Thanks for reading this and have a Great Day!!
GO TITANS!!!!!!!
Love, Stacy
Thanks for reading this and have a Great Day!!
GO TITANS!!!!!!!
Love, Stacy
Hi Stacy,
I've never heard of this happening to any one before. What a nasty thing to do to someone. How on earth can the ins. co. say that your moms or anyone else's surgery wasn't a necessity especially after doing so well after the surgery and proving that their health is so much better than before. Keep us posted on this please. It would be interesting to know the outcome.
God Bless!
Tammy P
I've never heard of this happening to any one before. What a nasty thing to do to someone. How on earth can the ins. co. say that your moms or anyone else's surgery wasn't a necessity especially after doing so well after the surgery and proving that their health is so much better than before. Keep us posted on this please. It would be interesting to know the outcome.
God Bless!
Tammy P
I agree with Tammy, if they do come back I think she will have enough information on the progress she has made and the money she has saved the ins company because she had WLS. It is just the thought that a panel of folks, often no doctors at all, can make a life or death decision for someone. I will say a prayer that nothing comes of this.
darlene
darlene
Darlene Hughes
k9ophile
on 11/23/08 3:31 am
on 11/23/08 3:31 am
BIG SCREAM! That is so bogus! I hope she still has all her paperwork, every little scrap. Will keep in my prayers since I have no real idea how to fight the turkeys.
"Our ultimate freedom is the right and power to decide how anybody or anything outside ourselves will affect us." Stephen Covey
Don't litter! Spay or neuter your pet
Dear Stacy :
I just want you to know that I had to read this twice before it actually sunk in. I can not believe this is happening to her. Especially after they approved and paid for it. Even moreso, after your mom already had the surgery !?!? That is insane ?!?!
Once they approve the surgery , you have one year to the date of approval (unless otherwise noted) to have the surgery. Where are they coming from with she had it performed too late ? When did she have her surgery ? And like I keep repeating in my head
- they already PAID for it?!?! WTH 
Stacy , I just want youto know we are all pulling for your mom. We need to have this law amended if there is such a law.
Please keep us updated.
Be Blessed,
EvoluTioN_GurL
I just want you to know that I had to read this twice before it actually sunk in. I can not believe this is happening to her. Especially after they approved and paid for it. Even moreso, after your mom already had the surgery !?!? That is insane ?!?!
Once they approve the surgery , you have one year to the date of approval (unless otherwise noted) to have the surgery. Where are they coming from with she had it performed too late ? When did she have her surgery ? And like I keep repeating in my head
- they already PAID for it?!?! WTH Stacy , I just want youto know we are all pulling for your mom. We need to have this law amended if there is such a law.
Please keep us updated.
Be Blessed,
EvoluTioN_GurL
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