What the heck am I going to do, this is bad, very bad?!

I hope you will share!

I just have to vent here because I am beyond speechless (well I guess not totally speechless)!

I got a letter from my previous insurance company saying that my claim has been denied. I had InterStim surgery done on Dec 7, 2010 and it was suppose to be covered. I actually told my urologist before the surgery that I could not do it, if it was not covered. They told me “we will not do it if it is not covered.” I said OK, so you will send it through my insurance and if it’s denied you will tell me?” they said “yes!”

Everything was fine and good to go. I had the surgery done and I figured everything was fine. I even called the hospital to make payment arrangements for my 20% and they said that the bill had not come through yet so I could not start making payments yet. Now it is April and still not set.

I got a letter today that said it had been DENIED! OMG,
I just sat there with my jaw to the floor. There was a hug number for what I owe and it is just above $52,000!! yes you read that right 52K!

I immediately called my urologist and they said they got paid back in Feb and to call my insurance so I did. As it stands now she said they actually requested the money back from my doctor and she could not make heads or tails of the “vague” notes on my account. I simply told her, there is no way I can pay this, I was assured the surgery would not be done if it was not covered.

Now I wait for a call back from the insurance company. What am I going to do if I have to pay the $52,000?! Hospitals can garnish up to 60% of your wages. We make under $48,000 a year for a family of 4 and we break even every month. I am just sitting here going, WT….!

Anyway, thanks for letting me vent today. I am literally sick to my stomach. I so don’t know what I am going to do!

I hope you are all having better days!

UPDATE posted on 4-29-2011

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9 Responses to What the heck am I going to do, this is bad, very bad?!

  1. productjunkiemama says:

    Tawna: This is absolutely ludicrous! Insurance companies are like sharks and give them the fight of their life! Why are you being left with the bag? Ridiculous! Thanks for stopping by my blog! Following you on GFC and FB! Glad to have you on board! I am going to read up on the results of this matter! Best wishes!

  2. Terry says:

    Holy Crap Tawna… That really sucks.

    You know, My insurance company just did the same thing. My charge was only $84 though. It was just for exrays etc..
    Insurance companys have always been sneaky in my book. They are just getting sneaker.

  3. Chana@ Mamma Town says:

    Hi! Love your blog! Found you through the weekend hops! Hope you'll swing by and return the follow! http://www.mammatown.blogspot.com

  4. Mrs. Organic says:

    That's terrible! I would see if your insurance company has a patient advocate who can help you through the appeals process. Make sure to file an appeal right away. It might just be a problem with how it was coded/billed. Let me know if I can help.

  5. Jen says:

    I've been through so many things like this. Yeah, don't give up or let them off the hook. It takes a bit and a lot of patients but you can get it covered.

  6. Traveling Tina says:

    Hey Tawna…going through something similar with our insurance company. They paid for everything but the doctors fees. Said that the surgery for my daughter was experimental after approving it. But yet they paid the hospital stay, the x-rays, the anesthesiologist crazy.

    Good luck to you in getting it straightened out.

  7. YUMMommy says:

    Most hospitals have financial assistance programs and grants now. I would call the hospital's financial department and see if you qualify for any. Until then just make small payments of whatever amount you can.

  8. Siv Maria says:

    I do not know all the details but I tell you what, sounds like a good story. You are a writer, so write. Newspapers eat up this kind of stuff and noone likes bad publicity. Calm down, get your facts straight and then write! Thats what I would do anyways, just saying.

  9. Margaret says:

    I had something like this happen to me a year or so ago. Be prepared for a fight with the insurance company but don't give up. Also most hospitals will write some of the debt off. The hospital I go to writes 60% of what I owe them off before I even get a bill. It takes alot of work and alot of phone calls but in the end it is totally worth it.

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