I recently had an MRI done on my shoulder that has been hurting me for months now and yesterday got a statement from my insurance company denying the claim. It seems I was supossed to call a number and get pre-authorization for the MRI. The said it was in my book and it was. What a screw up. I am afraid I am going to be stuck paying the $1500 bill for it. This is making me physically ill from worry.
Insurance sucks. I have a BC/BS PPO. It doesn't pay nearly as much as the Aetna HMO our company used to have, and doesn't cover many things. For instance, my coworker's son needed X-rays after being brought to the emergency room. The insurance covered the ER visit, and would cover most of a hospital stay if needed, but the X-Ray department in the hospital was a separate organization and didn't take BC/BS! So he had to pay out of pocket for the X-rays!
Don't worry too much. You can usually pay something like this off incrementally, and as long as the hospital is getting their $$$ they won't be too ass-holish about it. Everyone knows the system is broken hard.
And actually, if you can prove that you can't pay it off, and you tell them that (in writing), it is my understanding that they can't go after any more of the money. Of course, you can't say you can't afford it and then be seen buying a 64' plasma TV....
First of all, it's the green room. Can't help yourself, can you? Second of all, it's better than what Canada has.
If there was supposed to be a predetermination done it sounds like the MRI company's billing department dropped the ball. The onus is on them to fix it, not you. I'd call 'em up and raise hell because this is their screw-up. But, if you want to cover your ass I'd call my local Blue's Customer Service Department. The number is on the back of your card. Tell them you want a "Non-Assigned Claims Form." Then turn around and call your doctor. Ask for a copy of your progress notes and a brief letter of medical necessity. After you get all that together take the paperwork from where you had the MRI, the progress notes, and the letter of medical necessity, and fill out the Non-Assigned Claims Form. Send it all in and wait on Big Blue to pull their head out of their ass.
you really want to go down this path? because i've a bollockload of NHS tales that make having to pay for an MRI scan look like a trip to disneyland.
Yep. At my poorest, when I was unemployed, I filled out a financial assistance form given to me by the hospital. After a week, I received 3 separate letters showing I owed zero balance. -J.
Don't worry about it, ep. There is nothing good that comes from such worry. What will happen, will happen. In the meantime, if it's okay, I'll pray that what will happen will be good for you. -J.
Forgot about this route. Thanks for reminding me, El. In the meantime, ep, don't be sick. Things will work out.
I got the statement the evening of the 23rd so it pretty much ruined my christmas time(though I had to work most of it). I should have called that damn number on the back of the card but somehow didn't realize I was supposed to. I have been working nights and will stay up all night and call them in the morning. Its kind of complicated because I have BC/BS of Georgia because thats what my company uses. Only the company is really kind of self insured and uses them to do the paperwork. I hope I can call and get some kind of rational decison. My doctor ordered the MRI after the physical therapy and cortizone shots didn't help with the pain after a month or so. I thought we had everything done at the Drs office when we scheduled the MRI and everything. If I have to pay it from my pocket it won't put me on the street or anything, but I can think of a lot more stuff I could spend it on. Thank you all for the support. What sucks is I am still in pain and hating myself for this mess. I'm a worrier by my very nature and stuff like this really gets to me. Working these swing shifts doesn't help with it all either. I should get me a day job, 13 years of going from 12 days to 12 hour nights every 2 weeks is getting to me, but its hard to give up the money. Sorry to be so down around the holidays.
First, don't be sorry. Bills and illnesses don't take holidays - otherwise there'd be more of us on holiday break than teachers and students. Second, sounds like your doctor's office also dropped the ball - they are supposed to know those things as well as the MRI office (at least MY doctor's office does). And with the new literature coming out showing how bad swing shifts are for workers, you'd think that the companies would look at ways to reduce or totally get rid of swing shifts. It might save them a boat load of money in insurance claims. So just sit back, enjoy a cup or glass of whatever you prefer and think good thoughts. I know most, if not all of us are pulling for you.
Update, I stayed up till 8am and called the insurance company and they said I could file an appeal (Makes me feel like a Texan on death row). They told me all this stuff that I need to get my drs. office to send to them. I called my drs office and told them all that and they said they would fax all the info and give me an update today. I got no call today while I slept. I called them back at 3pm when I got up and they still had not done it yet. Said it might be tomorrow afternoon God this is frustrating I went to the gym and did some cardio after that.
Rule one - keep calling the same day to make them get the paperwork done faster. The faster they get the paperwork faxed in, the faster they get rid of your persistent (irritating) calls.
bump. I called the DRs office this afternoon and they have finally faxed all the info in. Now they said its just a wait and see game. Usually 3-5 business days before an answer is recieved. I need some valium
Good news, I got a letter today from the insurance company saying that they have reviewed it and are going to pay This had me so upset that I had my doc give me something for my nerves last thursday. I am still having kne pain and my shoulder pain is not so bad now and having this 1500 dollar load off my back makes me feel better.
Ah, but did you remember to check with your insurance company and get the stress prescription approved?
