Insurance vent - ProTeacher Community




Home Join Now Search My Favorites
Help


      Retired Teachers


Insurance vent

>

Reply
 
Thread Tools
Keltikmom's Avatar
Keltikmom Keltikmom is offline
 
Joined: Mar 2013
Posts: 6,842
Senior Member

Keltikmom
 
Keltikmom's Avatar
 
Joined: Mar 2013
Posts: 6,842
Senior Member
Insurance vent
Old 12-07-2018, 01:32 PM
 
Clip to ScrapBook #1

Thank goodness Iím retired and can spend hours on the phone.

I had a colonoscopy in September and foot surgery (out patient) in October.

I have been fighting with Aetna since September over bills for both. We finally straightened out the colonoscopy bill last week.

As to the foot surgery: they said the doctor was in network, but his facility is not.

I contacted Aetna before the surgery, spent an hour on the phone, and was told everything was in network. No worries.

You know whatís coming.....

I have been on the phone with Aetna 4 times since the surgery asking why they arenít paying the bill. Iíve called so many times, today I got the same person I talked to last time. Every time they tell me...oh, wait, the facility is in network. We will reprocess.

Today, I was told ďWeíre sorry we all gave you the wrong information. Aetna doesnít partner with Facility X since last January. You should have gotten a letter. But I can help you start an appeal.Ē

I was so frustrated i hung up and cried. Thereís got to be a better way to talk with insurance companies.




Since


Keltikmom is offline   Reply With Quote

Renea's Avatar
Renea Renea is offline
 
Joined: Jan 2006
Posts: 10,986
Senior Member

Renea
 
Renea's Avatar
 
Joined: Jan 2006
Posts: 10,986
Senior Member

Old 12-07-2018, 01:57 PM
 
Clip to ScrapBook #2

Gosh, it makes you want to record every conversation you have with Aetna, doesn't it? Then you would have evidence of their incompetence.

I understand your distress when dealing with duplicitous insurance companies.
Renea is offline   Reply With Quote
ZipLine's Avatar
ZipLine ZipLine is online now
 
Joined: May 2009
Posts: 5,593
Senior Member

ZipLine
 
ZipLine's Avatar
 
Joined: May 2009
Posts: 5,593
Senior Member

Old 12-07-2018, 02:05 PM
 
Clip to ScrapBook #3

How frustrating! I hope you get it resolved. I really hate it when businesses/their employees are incompetent and provide inaccurate information. Donít blame you at all for crying with that stress!
ZipLine is online now   Reply With Quote
klarabelle's Avatar
klarabelle klarabelle is offline
 
Joined: Jul 2008
Posts: 17,226
Senior Member

klarabelle
 
klarabelle's Avatar
 
Joined: Jul 2008
Posts: 17,226
Senior Member

Old 12-07-2018, 09:52 PM
 
Clip to ScrapBook #4

Talk through your State Department of Insurance's Commissioner.
klarabelle is offline   Reply With Quote
amiga13's Avatar
amiga13 amiga13 is online now
 
Joined: Feb 2014
Posts: 13,621
Senior Member

amiga13
 
amiga13's Avatar
 
Joined: Feb 2014
Posts: 13,621
Senior Member

Old 12-08-2018, 06:47 AM
 
Clip to ScrapBook #5

I am so very sorry for you! I feel your pain. Iíve been going the rounds about insurance since April. I have spent so much time on this. I recently told a wise friend Iím thinking of giving up, she advised, ďDonít. Thatís what they want you to do.Ē

Good luck!


amiga13 is online now   Reply With Quote
anansi's Avatar
anansi anansi is offline
 
Joined: May 2009
Posts: 2,061
Senior Member

anansi
 
anansi's Avatar
 
Joined: May 2009
Posts: 2,061
Senior Member

Old 12-08-2018, 06:01 PM
 
Clip to ScrapBook #6

What a frustrating mess! I'm so sorry you have to deal with all this - first the indiginities of a colonoscopy and now an un-covered surgery. Grrrrr!!!!! Insurance companies seem to have waaaay too much power over our healthcare and getting this kind of run-around compounds it. I hope you get it sorted and quickly.
anansi is offline   Reply With Quote
marguerite2 marguerite2 is online now
 
Joined: Oct 2013
Posts: 1,783
Senior Member

marguerite2
 
Joined: Oct 2013
Posts: 1,783
Senior Member

Old 12-08-2018, 08:48 PM
 
Clip to ScrapBook #7

You've got company in medical Hades.

I've been on the same blood pressure med for years. Even before retirement have used the same pharmacy chain. Following procedure I call the pharmacy to renew my pills, but I have no more refills so they have to call the doctor. Doctor office calls back same day. Great.

But, I get a phone message the pills are on order. Next day another message pills are on back order and they have called my doctor about changing my med, but the doctor isn't calling back.

I call the pharmacy. They say the manufacturer stopped producing this pill and they are trying to line up a new source. No store in the chain has this med. But, if I want I can call around and see if another pharmacy chain has some and transfer the prescription.

I find the pills in a store of a different pharmacy chain across town. Great. Then I find out this pharmacy is not in network. The pills are cheap so I just paid for them.

I then dig out my insurance papers and realize that only one pharmacy chain, the one currently without my meds, is now on the insurance. Thankfully, it was the cheap pills, not the expensive ones that they didn't have or I'd be deeper in Hades asking for an exception to use an out of network pharmacy. We all know how accommodating insurance companies are (not).

Quote:
Today, I was told ďWeíre sorry we all gave you the wrong information
My favorite answer. My husband had to have a procedure done. We called. They preauthorized. He had the procedure. They paid the hospital. Then they took back the money and we got a huge bill. They said they made a mistake and should not have preauthorized. They said our insurance only covered that procedure in the office. Hospital outpatient not covered.

Sorry this is happening to you. Insurance is supposed to ease stress, not increase it.
marguerite2 is online now   Reply With Quote
amiga13's Avatar
amiga13 amiga13 is online now
 
Joined: Feb 2014
Posts: 13,621
Senior Member

amiga13
 
amiga13's Avatar
 
Joined: Feb 2014
Posts: 13,621
Senior Member

Old 12-11-2018, 06:36 AM
 
Clip to ScrapBook #8

Quote:
Then they took back the money and we got a huge bill.
OMG, marguerite, I didnít even know taking back the money was a possibility. Iím so sorry this happened to you.
amiga13 is online now   Reply With Quote
Renea's Avatar
Renea Renea is offline
 
Joined: Jan 2006
Posts: 10,986
Senior Member

Renea
 
Renea's Avatar
 
Joined: Jan 2006
Posts: 10,986
Senior Member

Old 12-11-2018, 11:39 AM
 
Clip to ScrapBook #9

Reading these stories frightens me. If you’ve been ill fighting the insurance company only adds to your distress. I’ve said this before but I’d be tempted to record my phone calls with insurance companies. I’d ask if their information was legally accurate and not subject to change. If not then they could put someone on the phone who could guarantee they were accurate.

What everyone here is reporting is crazy! We must be able to depend on what the insurance companies tell us. If patients follow the company’s directives who protects the patients when they’re given misinformation? This is madness.
Renea is offline   Reply With Quote

Join the conversation! Post as a guest or become a member today. New members welcome!

Reply

 

>
Retired Teachers
Thread Tools




Sign Up Now

Sign Up FREE | ProTeacher Help | BusyBoard

All times are GMT -8. The time now is 07:31 AM.


Copyright © 2017 ProTeacher®
For individual use only. Do not copy, reproduce or transmit.
source: www.proteacher.net