Hello!
I had recently a surgery. I made sure that my surgeon was in-network. It was a disk replacement and my selected surgeon (spine surgeon) had to bring an “opening surgeon”. For my surprise, she is out-of network and was not told, It is the only opening surgeon my spine surgeon works with.
The problem starts here, My spine surgeon submitted the claim to the insurance (pre -approved) so did the other surgeon.
Now, I got a letter from my insurance that they can not approve it because it was showing in my record I already had one. The office of this opening surgeon sent me a form to sign so her office can Appeal. In the letter she states: “You will only be responsible for coinsurance and deductible”. Knowing that she is out of network, this bill is going to be HIGH.
Should I sing? Can I appeal after if i get a surprise billing like this? or should I complain to the board about this predatory practices? she has done this in the past as per her google reviews.
ANY help will be appreciated. Thank You!
(I am in Texas)
submitted by /u/engineerscience88
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Hello! I had recently a surgery. I made sure that my surgeon was in-network. It was a disk replacement and my selected surgeon (spine surgeon) had to bring an “opening surgeon”. For my surprise, she is out-of network and was not told, It is the only opening surgeon my spine surgeon works with. The problem starts here, My spine surgeon submitted the claim to the insurance (pre -approved) so did the other surgeon. Now, I got a letter from my insurance that they can not approve it because it was showing in my record I already had one. The office of this opening surgeon sent me a form to sign so her office can Appeal. In the letter she states: “You will only be responsible for coinsurance and deductible”. Knowing that she is out of network, this bill is going to be HIGH. Should I sing? Can I appeal after if i get a surprise billing like this? or should I complain to the board about this predatory practices? she has done this in the past as per her google reviews. ANY help will be appreciated. Thank You! (I am in Texas)
submitted by /u/engineerscience88 [link] [comments]Read Morer/HealthInsurance