Sunday, May 10, 2009

Insurance Issues

Insurance companies are such a pain in the butt. Period. In 2007, the very first surgery, my health care provider denied payment on part of my surgery. The reconstruction part. They sighted that they only pay for jaw surgery due to cancer or acute traumatic event. Well having a tumor the size of an iPod nano aggressively growing in your jaw and eating away the bone is traumatic. The invoice... $4,500 dollars. Regardless, I had the doctor write a letter of necessity and I filed an appeal. I was pleased with the out come as the insurance company decided to pay. GOOD

Fast forward to November 2008. 3rd surgery to remove infection and place the implants and continue with reconstruction surgery. My insurance came back and denied that too, sighting the same thing. The bill... almost $10,000. After yet another letter and an appeal I got the happy news that they would pay. Thank you!

Now after two weeks from getting that letter, I got a summery of charges to date stating that I owe that same amount they just said they would pay!! WHAT? Either the left hand does not know what the right hand is doing or they changed their minds. I figured if they did change their minds I would get another letter stating such.

Surgery is so stressful. This last 2 years have been crazy. Now I have to battle it out with the insurance company. UGH! I can not say I was not warned. Over at the Yahoo! Support Group I would hear stories about such things. How they have to keep appealing and "fighting the system". It's just not fair.

1 comment:

Tina said...

i am so sorry to hear all of this. it almost makes me feel guilty that i am doing a case study on my own amelo reconstruction when i hear what you guys are going through. its such an extra kick in the pants. :(

how did this turn out? any updates??