I received a terrifying letter yesterday.....UPDATE! OVERTURNED!!!!!

[ChicknThief]

Thank you guys so much for the info and support. I usually take my lunch around noon. I am really hoping that this is a mere clerical error and can be solved quickly over the phone. Nothing else makes any sort of sense. No one in their right mind would have denied the emergence of my situation if they could have seen me that night. It was pure, unadulterated agony. I don't know if I was just allergic to the medication, or if it was a bad batch, or??? Either way, I am NEVER buying generic medication again. It's worth a couple extra bucks to go with something that you have used before and you KNOW will work. IMHO. In this case, paying a couple extra bucks could possibly have saved me more than 1500$.

 

[Ksane]

Quote:
I have always been told that if a person doesn't have insurance and they go to the ER, that they don't pay out of pocket. That it goes to the taxpayers? Though from the sound of your story, it seems that my information is incorrect. And re-reading it now that I am calm, it was grossly insensitive and ignorant. I am so sorry. I am going to go back and edit that.

Oh heck no lol! We're taxpayers and that's part of the reason we flat don't have the $500/month for medical insurance (that covers very little anyway). What angers me if that WE'RE paying for those on medicaid to get free medical treatment yet we can't afford it ourselves. We'll be paying on this $1600 bill for a long time. You *have insurance and your ER visit should be covered. That's totally unfair for them to deny the claim. You shouldn't have to pay the outrageous cost of insurance every month PLUS have to pay your ER visit, that's wrong of them.

 

[ChooksChick]

Appeal, appeal, appeal. Get itemized bills from the ER. Get copies of what they submitted to the insurance. Do all of this immediately, as there are very specific timeframes you must adhere to in order to win. Do not drop any balls in this process.

Find out what your insurance plan defines as an emergency. Find out what the symptoms you were having were called, and find out what other professionals describe this event as out there on the web. If you can show it was an emergent situation in other people's cases, you have evidence of that as a normal procedural response. Please follow through and do due diligence. You can easily win.

 

[critterrun]

it just might be a mistake

call and explain the pain
hoe YOU COULD NOT BREATH

and how you fell to the floor

That is a valid claim for the ER

 

[pips&peeps]

Quote:
I was a medical biller and did some claims too and I agree. But as a biller, the first thing I would have done is to check this stuff myself. It is quicker and easier to get paid from an insurance company than to have a "private pay".

 

[ChicknThief]

Whoohoooo!!! I called on my lunch break today and got bounced around for a bit in their automated system. When I finally got to a real person, I explained what I had gotten in the mail, and the whole situation. The man was very kind and aplogized for the scare. Apparently, the ER doctor failed to mention in his report that I was having an extreme reaction to medication when I came in!

So it appeared to my insurance that I had gone to the ER for a simple infection that could easily have been taken care of by other means. The guy apologized, assured me that the bill would be paid in full, and that there would be no further trouble!

 

[HeatherLynn]

I was about to mention it was probably how the doctor coded it. I had that happen before. It was simple to fix once we discovered what had happened. To the insurance though it looked like something they should not cover because a couple codes were entered wrong. Total pain in the rear. I know some complain about their insurance and mine is not perfect but they seem willing to work with us when there are mistakes.

Glad it was taken care of.

 

[Ksane]

I'm so glad for you!

 

[dainerra]

Quote:
The reason people say this is that WAAAAY too many people just walk out the door and never pay their bill. So the costs get passed on to all future customers.
And, unless it is a county hospital that is required to treat people, most hospitals and doctors require a size-able upfront payment from any patient that doesn't have insurance.

 

[BrattishTaz]

Quote:
Just make sure you keep checking the status of the payment. I have had to deal with insurance billing issues on several occasions. Always document who you spoke to and exactly when you spoke to them. Technically, if it isn't in writing, it was never said.

I hope they get it resloved for you without further issues.