Insurance problems down the road, appeals

[Aginn10 82]

When I had my first consult i had met my deductible and then they call amd verify everything and insurance told them yes it was met and everything is covered 100%, I have several documents stating that. But here it is 4 months later, and I see where BCBS paid hardly ANY claims, they said it was out of network, like the anesthesiologist snd several others. I made sure to be in network with all people I knew about but was i supposed to wake up mid surgery and ask everyone if theyre on BCBS?!?!? Im talking $30,000 in claims. Any one experience this? did you appeal? Howd it go? They denied my Vitamin D test even!!! It was $300, and ive even been diagnosed with Vitamin d deficiency in the past andhad to take meds for it?!!? Im very upset!!

[momin2005 30]

I would appeal!! I would also be talking with the facility where you had surgery, they had your insurance information and should have d made sure anyone involved in your surgery was covered. I would be so upset! Hope you get this resolved.

[kfulcer 31]

I agree!! Appeal. The instructions are on the back of the EOB from your insurance.

Sent from my SAMSUNG-SM-G928A using BariatricPal mobile app

[BGrundee 61]

This happened to me on a smaller scale. I was at an "in network" facility to get my blood work done. Unfortunately, the person who took my blood, sent my blood to an out of network lab. I was billed a little over $700 dollars and insurance would not cover this what so ever. I had to make calls and challenge the office management on how this could happen. No one wanted to own up to it and kept pointing fingers to another person. At the end of the day, I didn't care whose fault it was because ignorance or lack of knowledge is not an excuse for negligence to ignore doctor orders. In my case negligence to send to the wrong laboratory, and your case schedule out of network people. Under Doctor's orders you were to be scheduled and should have been seen by the right the In network people.

For me, the out of network laboratory made my balance a zero because it turned out the girl who took my blood was an actual employee of the laboratory and outsourced to draw blood in my "in network" facility, however she must always follow doctors orders and rules of insurance. On the day she took my blood, she didn't read my insurance card and sent it to her home corporate laboratory.

I would talk to the coordinator that compiled your team together and demand why it was over looked or not shared before hand of use of out of network staff. Tell them you will not pay it as its negligence and file a billing complaint with the Department of Managed Health Care in your state. You should not pay for someone elses rookie mistake.