yoopermom
Come join Bravo by the fire...
- Joined
- Sep 27, 2000
(I've had three surgeries in three years on the same ankle/foot due to a serious fall and its complications, so I think I'm pretty savvy when it comes to doctors/insurances/etc, however....)
My maximum OOP has been reached for the year, so I've been happily checking my insurance website, watching the EOB with zeros on them for my part due. Yesterday, it suddenly showed over 8K in new charges due (half to surgeon, half to assistant surgeon). I called the insurance company immediately, and the rep said that the surgery was preauthorized, but one of the six coded procedures that he did was NOT preauthorized, so they denied it. My immediate thought was, "How can I be responsible for knowing this, I was sound asleep on the operating table!", but I know that that doesn't always matter.
I called the surgeon's office this am, and the billing department is "looking into it". I know I have to let the process take its time, but I'm just sick to my stomach. I made sure, ahead of time, that everyone was in network, and that the preauthorization had taken place. How can they hold me responsible for a decision that he made, especially one that was made while I was under? Can I hope that maybe it was just a coding error? Or??
TIA!
Terri
My maximum OOP has been reached for the year, so I've been happily checking my insurance website, watching the EOB with zeros on them for my part due. Yesterday, it suddenly showed over 8K in new charges due (half to surgeon, half to assistant surgeon). I called the insurance company immediately, and the rep said that the surgery was preauthorized, but one of the six coded procedures that he did was NOT preauthorized, so they denied it. My immediate thought was, "How can I be responsible for knowing this, I was sound asleep on the operating table!", but I know that that doesn't always matter.
I called the surgeon's office this am, and the billing department is "looking into it". I know I have to let the process take its time, but I'm just sick to my stomach. I made sure, ahead of time, that everyone was in network, and that the preauthorization had taken place. How can they hold me responsible for a decision that he made, especially one that was made while I was under? Can I hope that maybe it was just a coding error? Or??
TIA!
Terri