Yarnspinner

Thank you for the kind words! The letter stated it was the final appeal for the medical provider. I'll try calling and escalating though. They have to provide me more info so I can appeal. I can't imagine they wouldn't cover the stents and all that entailed, but they covered the visiting nurse and antibiotics when I was released after all that? It just doesn't make sense.

Has anyone run into this? My insurance covered the surgery and I was approved with no problem. Unfortunately, about a week out I had an infection and then a leak. I was in and out of the hospital 3 more times over 5-6 weeks. The last time I was probably in for a couple weeks straight. I don't really remember because of the meds. I had to have another procedure to put stents in and another to take them out. There was a picc line that the insurance said they would only cover in the hospital while taking nutrition. They paid for a visiting nurse when I was released and used the picc line for antibiotics. They are currently paying for nutritional supplements. My doctor or the hospital got approvals for my stay and procedures each time they needed me to stay longer. I am so confused. Last week I received 2 letters from my insurance insurance denying 2 big claims, totaling about $65k. I think these claims are mostly related to the stay resulting from the second procedure. I think these bills probably include the second procedure? Anyway, they denied the medical provider's final appeal stating it wasn't under the policy. The letter states that I can appeal. I called and they said I could write a letter but they wouldn't send me any of the documentation. They said I needed to speak with the medical provider. I called the hospital and they said to call the doctor. I haven't been able to get in touch with them yet. I don't really know exactly how this isn't covered and I don't really know how to start. Has anyone else encountered this? The last hospital stay was because I couldn't even keep Water down and the insurance company wouldn't allow me to receive 2-3 weeks of nutrition through a picc line without being in the hospital. Neither I, nor anyone in the hospital, thought I could recover without food and water that long. Obviously.... I'm wondering if they found this not medically necessary? Has anyone had to appeal medical bills afterward for things that you think should be covered? I never thought I would end up with this much to pay. I want to file the appeal but I'm not really sure how to go about it. My insurance company is BCBS OK but I live in another state.

My surgery for the sleeve and hernia repair went well 10 days ago. I was having a problem free recovery. No nausea. Decent intake of liquids. After a week, I developed a high fever. We called the doctor, they set up a CT scan and told me to come in. I was admitted after the test. They did a swallow test the next day. I was advised it didn't look like a leak, but was suspicious. My doctor is really attentive, concerned and I don't have any issues with his care. I was in the hospital 3 days. After the swallow test on Friday, I was told the mass hadn't gotten any bigger. My white cell counts are lower. while there, I didn't get any of the medication that controls my asthma. My mother snuck some in, but I had a long day with bad allergies and stuff settled in my lungs. On Friday, they said my lungs had deteriorated, too. I knew they had because I had a constant wheeze. Since getting out yesterday, I've cleared my runny nose, cleared up my wheeze and put in extra time in the spirometer. My mother has been watching me and monitoring my vitals. I spent a little time with my roommate and cats this afternoon. It wiped me out. I came home. I thought I was doing better, then I was overcome by violent shaking, chills and hyperventilating. Mom called 911. They said my vitals were ok. No sign if stroke, seizure or heart attack. Maybe an anxiety attack? We were just getting ready to go out. No stress. But I have been really emotional lately. Maybe it was. I chose to stay here, since I was breathing again. I think I can treat my lungs better here. I'm upright and move around more, plus I can use my nebulizer. Then to top it off, I weighed myself at the house. I went into the surgery at 346. I think I lost 20 on the pre op diet. It said I gained 8 pounds! I'm still on a phase 1 liquid diet. At the hospital, I only had a few sugar free Popsicles and Water for three days! I had gotten up to pudding and yogurt, before going in the second time. I didn't have that much if it. It would take me an afternoon to get through a carton. Now my temperature seems to be up again. I don't know what to do. I'm getting my lungs under control. Has anyone had these setbacks and gotten through it? I'm feeling quite frustrated and depressed now. I'm worried about the internal infection. Maybe I shouldn't have done this. So far I have had a world of trouble and gained weight!