The Venting Thread

[evil_physics_witchcraft]

My insurance company denied my surgery saying that it wasn't 'medically necessary.' Really? REALLY???????

[FishProf]

My insurance company denied my surgery saying that it wasn't 'medically necessary.' Really? REALLY???????

Really.  They'll do just fine without it.

What? You thought this was about YOU?

[clean]

My insurance company denied my surgery saying that it wasn't 'medically necessary.' Really? REALLY???????

Im sure that the doctor's office can file some additional paperwork to show that it is. 

Otherwise perhaps you can call your HR department and ask them about an advocate.

(I was assigned a BCBS nurse once. Im not sure why... It was after I was in the hospital, but I am not sure that it was related to the hospital visit or they happened to cold call me with my 'new benefit' at the right time.  She was able to cut some red tape for me as doctor's offices tend to answer calls from insurance companies and other health professionals.)

[cathwen]

After I had cataract surgery several years ago, my insurance company stunned me by denying coverage.  What, do they think it's okay for me to go blind?  Is that acceptable?  How can they not cover cataract surgery? 

In the end, a mediator worked her magic and they ended up paying, but good grief. What an unnecessary hassle.

[evil_physics_witchcraft]

By a miracle from Odin, my doctor spoke with the insurance company and they decided that yes, I do need surgery. Fuckers.

[clean]

OMG... Insurance!! 
Surely a realm of Hell!

In October 2018 I was hospitalized with pulmonary embolisms (both lungs).  I only stayed one night because they were unable to find any more blood clots that they feared may break off and make things worse.  (The damage was already done)  So I was not required, though I had the option to stay a second night. 

Weeks later, I got a letter from the insurance company (BCBS) that I was approved for one night!  So I am glad that I chose not to stay longer as I would then have had to fight for the added coverage! 

Bastards! 


Even Today!  A recently retired coworker's husband is dealing with Humana for her husband. He had a stroke last week and the doctors and rehab facilities are ready to move him, but Humana has yet to approve it!  Humana claimed "no one put a rush on it"  from the doctor or rehab.  My former coworker is NOW having to get an attorney to draw up a Health Care Power of Attorney because Humana will not deal with my coworker (and her hubby had a stroke so he needs the rehab in order to be understood when he talks!!)

Fortunately, I already have 2 health care power of attorney people (with the HIPA releases that are needed as well). 

Anyway!  Evil Physics Wichcraft, have a good weekend before your NOW Covered Surgery!!

[evil_physics_witchcraft]

OMG... Insurance!! 
Surely a realm of Hell!

In October 2018 I was hospitalized with pulmonary embolisms (both lungs).  I only stayed one night because they were unable to find any more blood clots that they feared may break off and make things worse.  (The damage was already done)  So I was not required, though I had the option to stay a second night. 

Weeks later, I got a letter from the insurance company (BCBS) that I was approved for one night!  So I am glad that I chose not to stay longer as I would then have had to fight for the added coverage! 

Bastards! 


Even Today!  A recently retired coworker's husband is dealing with Humana for her husband. He had a stroke last week and the doctors and rehab facilities are ready to move him, but Humana has yet to approve it!  Humana claimed "no one put a rush on it"  from the doctor or rehab.  My former coworker is NOW having to get an attorney to draw up a Health Care Power of Attorney because Humana will not deal with my coworker (and her hubby had a stroke so he needs the rehab in order to be understood when he talks!!)

Fortunately, I already have 2 health care power of attorney people (with the HIPA releases that are needed as well). 

Anyway!  Evil Physics Wichcraft, have a good weekend before your NOW Covered Surgery!!

Thanks, Clean.

Yes, insurance companies are beyond the Ninth Circle of Hell. So tired of companies profiting off our health (good or bad).

[Larimar]

By a miracle from Odin, my doctor spoke with the insurance company and they decided that yes, I do need surgery. Fuckers.

Glad to hear it will be covered. Wishing you a successful surgery and a quick and complete recovery. And that when you get home, you get swarmed by loving, snuggly kitty cats.

[evil_physics_witchcraft]

By a miracle from Odin, my doctor spoke with the insurance company and they decided that yes, I do need surgery. Fuckers.

Glad to hear it will be covered. Wishing you a successful surgery and a quick and complete recovery. And that when you get home, you get swarmed by loving, snuggly kitty cats.

Thanks Larimar. :)

[evil_physics_witchcraft]

After I had cataract surgery several years ago, my insurance company stunned me by denying coverage.  What, do they think it's okay for me to go blind?  Is that acceptable?  How can they not cover cataract surgery? 

In the end, a mediator worked her magic and they ended up paying, but good grief. What an unnecessary hassle.

That's ridiculous! I'm glad the mediator got the company to cover the surgery.

[evil_physics_witchcraft]

And this is why I double and triple-check things. Called the insurance company and they have no such record of my doctor speaking with them, or an approval. Waiting to call the doctor back (they're on lunch).

Grr.

[Cheerful]

And this is why I double and triple-check things. Called the insurance company and they have no such record of my doctor speaking with them, or an approval. Waiting to call the doctor back (they're on lunch).

Grr.

Yes, smart to confirm.
Why has our society become so error-laden?  Seems rampant.  People not paying attention to detail, errors, telling you something's addressed and you find out it's not, etc.  Sorry you're having to go through all of this.  Gonna feel great to have it all behind you soon!

[downer]

And this is why I double and triple-check things. Called the insurance company and they have no such record of my doctor speaking with them, or an approval. Waiting to call the doctor back (they're on lunch).

Grr.

Yes, smart to confirm.
Why has our society become so error-laden?  Seems rampant.  People not paying attention to detail, errors, telling you something's addressed and you find out it's not, etc.  Sorry you're having to go through all of this.  Gonna feel great to have it all behind you soon!

I'm not sure about other areas of life, but my main hypothesis regarding health insurance is that that their goal is to dissuade people from following up, and generally make them give up the fight. The more dispiriting they make the experience, the better for them.

So far I've had very little to disconfirm my hypothesis.

[Larimar]

Yep. Insurance companies are in the business of avoiding paying whenever and however they possibly can.

Last summer I had to have dental surgery. I had to pay the whole $8000+ cost up front to get the procedure done, and I had to take out a new line of credit in order to do that. It then took 3 months for the insurance company to reimburse me. There were a lot of phone calls in the meantime just to find out what was going on, and then the double checks.

I don't intend to forget about this.

[ab_grp]

Argh, insurance companies!! Don't get me started.   I'm deleting my rant because each time I try to edit it down I just expand upon it further.  Anyway, venting in solidarity! Hope it gets sorted quickly and easily, EPW.

I'm not sure about other areas of life, but my main hypothesis regarding health insurance is that that their goal is to dissuade people from following up, and generally make them give up the fight. The more dispiriting they make the experience, the better for them.

So far I've had very little to disconfirm my hypothesis.

YES