I recently had an emergency surgery. Went to the ER, diagnosed with appendicitis. Had an appendectomy that started as lapriscopic that would likely be outpatient, but they ended up converting to fully opening me and also performing a cecectomy to remove part of my colon and a mass that was found. Because of this, I was admitted and spent 2 nights and 3 days in the hospital before being discharged.
I’m now getting claims coming in, and even though the facility/hosptial is in network, most of the providers were not. The surgeon was lucky in network, but the pathologist, CT tech, ER doctor and anesteologist were not in network. So far I’m at $4k in claims, and no claims have came through for the hosptial stay itself or the surgeon, so I know there is plenty more to come
I’ve received a letter from my insurance (UHC AllSavers), telling me my whole claim is being denied due to it not being medically necessary. The hosptial said they held a peer to peer review with them and they should be over turning that decision, but nobody at UHC will tell me anything.
Is there anything I can do? When I’m in excruciating pain am I really supposed to look into each provider to ensure they are in network before having anything done, when it’s considered an emergency? Also, when looking up the anesteologist, I discovered that my insurance has ZERO anesthesiologists in network at the in network hospital I went to. Also none in network at the only other hosptial in my town. How does this work in terms of needing any surgery?!
My deductible is $5k, so I already know I’m going to have close to that much in bills. None or my out of network stuff goes toward my deductible, so I’m worried I’m going to end up paying $10k+ by the time it’s all said and done.
Is there anything I can do that I might not be aware of?
submitted by /u/Salt-Button
[link] [comments]I recently had an emergency surgery. Went to the ER, diagnosed with appendicitis. Had an appendectomy that started as lapriscopic that would likely be outpatient, but they ended up converting to fully opening me and also performing a cecectomy to remove part of my colon and a mass that was found. Because of this, I was admitted and spent 2 nights and 3 days in the hospital before being discharged. I’m now getting claims coming in, and even though the facility/hosptial is in network, most of the providers were not. The surgeon was lucky in network, but the pathologist, CT tech, ER doctor and anesteologist were not in network. So far I’m at $4k in claims, and no claims have came through for the hosptial stay itself or the surgeon, so I know there is plenty more to come I’ve received a letter from my insurance (UHC AllSavers), telling me my whole claim is being denied due to it not being medically necessary. The hosptial said they held a peer to peer review with them and they should be over turning that decision, but nobody at UHC will tell me anything. Is there anything I can do? When I’m in excruciating pain am I really supposed to look into each provider to ensure they are in network before having anything done, when it’s considered an emergency? Also, when looking up the anesteologist, I discovered that my insurance has ZERO anesthesiologists in network at the in network hospital I went to. Also none in network at the only other hosptial in my town. How does this work in terms of needing any surgery?! My deductible is $5k, so I already know I’m going to have close to that much in bills. None or my out of network stuff goes toward my deductible, so I’m worried I’m going to end up paying $10k+ by the time it’s all said and done. Is there anything I can do that I might not be aware of? submitted by /u/Salt-Button [link] [comments]Read Morer/HealthInsurance