Insurance Co. Doesn't Want To Pay For Anesthesia

[gmanbat 5,889]

We have a tussle with our insurance company, Medical Mutual of Ohio, every time we get an operation. They always balk at paying for the anesthesia. When my wife had roux n y they refused, then said ok. When I had my gall bladder out the same, and now they are refusing to pay the anesthesia for my sleeve. They are saying the anesthesia people at the hospital are not submitting the proper paperwork but it makes me nervous to be on the hook for $2,600.

I'm a tough guy but I don't think I could have just bit on a stick while Dr. Lalor cut me, blew me up with air, stapled and cut and sewed me up. Even my machismo has it's limits.

[Lyra 43]

Sheesh, do they expect the doctor to hit you over the head with a big stick? Or do it the cowboy way and just get you drunk on cheap whiskey? Weird.

[longer-life 139]

I'm a tough guy but I don't think I could have just bit on a stick while Dr. Lalor cut me, blew me up with air, stapled and cut and sewed me up. Even my machismo has it's limits.

LOL

Insurance companies can be so stupid sometimes! They should be dealing with the hospital about this. It's not like you didn't use anesthesia! ARGH! I would also call the surgeon (or someone on his team) and ask them to help you out.Also perhaps someone in the hospitals billing department. I hope you get this resolved soon.

[Rootman 1,101]

Yikes! I'm no expert but I've NEVER heard of an insurance company refusing to pay for anesthesia. I've heard of them refusing for dental procedures but never surgical.

Seems like your only route is to get a WRITTEN assurance of pre-authorization and then make them stick to their promises.

We all wish you well.

[Ms skinniness 3,003]

The bariatrics department sent Kaiser a bill and my surgery was approved before they gave me a referral. I kept getting bills for $49,000 stating that they were denied. When I spoke with Kaiser, they told me that they had not received the correct billing from the bariatric surgeon. They told me not to worry about it, and after a few more denials, the insurance company paid it. I was really sweating there. LOL

[alexeleni 15]

That's completely ridiculous. Silly me, thinking anesthesia was part and parcel of GIANT MAJOR SURGERY.

[gmanbat 5,889]

I got a letter from the hospital anesthesia people today trying to bill me for $1600. They said the insurance company refused to pay. Last week I got a letter from the insurance company saying they were sending a letter to the anesthesia people wanting more paperwork before they pay. I don't know if the insurance company turned it down a second time or the anesthesia people just have not sent in more paperwork yet to get it approved. I tried to call the anesthesia people, all automated, no people to talk to. I will call the insurance company tomorrow, maybe they know what is going on.

Tomorrow I have a follow-up with my surgeon, I will let him know what a mess the anesthesia people are and the insurance company, too. Maybe he can kick some butt and get this resolved. This is getting old.

[Ms skinniness 3,003]

This happened with my insurance company and the hospital where the surgery was done. My insurance company told me that they were waiting for the correct paper work before paying it. And it was true, they finally paid it. Sit back and try to relax and it will work out.

[gmanbat 5,889]

Update:

My little wife has a way with the phone. She can mask her anger much better than I can. She called the insurance company today and explained the situation to them. Today we got a reasonable person on the line, thank God. They checked to see if the operation was originally approved and, of course, it was. Then they said they would just mail them the check. No hassle about correct codes, etc. My wife called the code illiterate anesthesia people and told them they will get a check within 2 weeks. They were satisfied, my thumbs are safe.