| [GMCnet] Welcome to Obama Care [message #284269] |
Sat, 08 August 2015 10:44  |
emerystora
Messages: 4442
Registered: January 2004
Karma: 13
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Senior Member |
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I just received a copy from Humana insurance of the billing for my second back surgery.
The total billed charges were $203,737.95. This is just for the hospital and doesn’t included the surgeon’s charge.
The total denied by the insurance was $202,269.03
The denied included charges for radiology, operating room, anesthesia, physical therapy, general pulmonary, ekg and recovery room.
Now I am scared as to how much they plan to bill me. If I have to pay $200,000 that will be the amount of Social Security that I will likely draw for the rest of my life.
I believe that I had to sign a form saying that I would be responsible for anything that the insurance didn’t cover.
The GMC content of this email is that if they bill me for the difference I may have to sell my GMC to raise money!
Emery Stora
77 Kingsley
Frederick, CO
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| Re: [GMCnet] Welcome to Obama Care [message #284270 is a reply to message #284269] |
Sat, 08 August 2015 11:14  |
JohnL455
Messages: 4447
Registered: October 2006
Location: Woodstock, IL
Karma: 12
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Senior Member |
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Best bet is to get an arbitrator and /or play dumb and drag it out ad nausium. . (Or tell them the work was not done to your satisfaction.) Hide the GMC somewhere as that won't put a dent in it. I think they, like all insurance, refuse at first and then you have to argue for it. The paper work is as bad as the hospital when you are still not feeling up to it. I think with name brand insurance you should only have to pay your deductable.
John Lebetski
Woodstock, IL
77 Eleganza II
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| Re: [GMCnet] Welcome to Obama Care [message #284271 is a reply to message #284269] |
Sat, 08 August 2015 11:16 |
Chris Tyler
Messages: 458
Registered: September 2013
Location: Odessa FL
Karma: 7
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Senior Member |
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many companies initially deny coverage. Also, many hospitals leave out documentation that would drastic;y reduce that
Talk with the hospital and request detailed billing as well as explicit reasons for denial
Pay what you can afford only. Dont let them bully you
BTW who is your carrier?
76 Glenbrook
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| Re: [GMCnet] Welcome to Obama Care [message #284272 is a reply to message #284269] |
Sat, 08 August 2015 11:16 |
A Hamilto
Messages: 4508
Registered: April 2011
Karma: 39
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Senior Member |
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emerystora wrote on Sat, 08 August 2015 10:44I just received a copy from Humana insurance of the billing for my second back surgery.
The total billed charges were $203,737.95. This is just for the hospital and doesn't included the surgeon's charge.
The total denied by the insurance was $202,269.03
The denied included charges for radiology, operating room, anesthesia, physical therapy, general pulmonary, ekg and recovery room.
Now I am scared as to how much they plan to bill me. If I have to pay $200,000 that will be the amount of Social Security that I will likely draw for the rest of my life.
I believe that I had to sign a form saying that I would be responsible for anything that the insurance didn't cover.
The GMC content of this email is that if they bill me for the difference I may have to sell my GMC to raise money!
Emery Stora
77 Kingsley
Frederick, CO Don't let it annoy you. Worst case is you have to hire a lawyer. Then get what the insurance denied, plus the lawyer and court costs, plus enough punitive damages to pay for some GMC upgrades.
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| Re: [GMCnet] Welcome to Obama Care [message #284315 is a reply to message #284269] |
Sat, 08 August 2015 18:23 |
jhbridges
Messages: 8412
Registered: May 2011
Location: Braselton ga
Karma: -74
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Senior Member |
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They hide behind one another. "Didn't get preapproval"..."not customary surgery".." etc." They hafta give a reason for each denial, usually they're BS. Remember, the first gerbil who sees the claim is in charge of not paying it.
Don't let it or them bother you. Recover and give them grief later.
--johnny
Foolish Carriage, 76 26' Eleganza(?) with beaucoup mods and add - ons.
Braselton, Ga.
I forgive them all, save those who hurt the dogs. They must answer to me in hell
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| Re: [GMCnet] Welcome to Obama Care [message #284470 is a reply to message #284457] |
Mon, 10 August 2015 09:48 |
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USAussie
Messages: 15912
Registered: July 2007
Location: Sydney, Australia
Karma: 6
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Senior Member |
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Pete,
I see you've noted dual citizenship; I'm a USAussie, how about you?
Here's the way the numbers stacked up for my recent left knee replacement in Aussie Dollars:
Parts:
St. Vincent's Hospital: Prosthesis - Surgical Implant (Bionic Knee) = $10,868.00
Accommodation:
St. Vincent's Hospital: Private Room - 5 days = $15,636.00
Wolper Rehab Hospital: 9 days = $5,571.00
Labor:
Professor Michael Neil (Surgeon) = $9,987.50 (I love the $0.50 - I didn't have the courage to ask him how he came up with that!)
Dr. S. Adamo (Anesthesiologist) = $2,680.00
Fiona Crawford (Theater Nurse) = $250.00
Miscellaneous Charges: $378.00
Total Charges: $45,219.50
Out of Pocket: $9079.92
Exchange rate: 1 AUD = $0.75 USD
I could have gotten the whole operation FOC if I went on a waiting list and had it done under Australia's Medicare system which
would had me wait until it was my turn (don't know when that would have been because I didn't ask), they would put me in the
hospitals of their choice for the surgery and rehab, I would not have had private rooms, they would select the surgeon, they would
select the anesthesiologist, they would select the theater nurse, they would select the prosthesis. Because I have private insurance
on top of my Australian Medicare I made all those decisions. Bottom line: I was rolled into the rehab hospital on a gurney and
WALKED out 9 days later! I had to use a cane but I walked out. When I got home I was able to climb and descend the 16 steps to the
second floor where our bedroom and bathroom are. It's been just over three months and I hardly know it was replaced.
Regards,
Rob M.
The Pedantic Mechanic
Sydney, Australia
-----Original Message-----
From: Pete Smith
Oh please! Private insurance companies routinely deny coverage until you badger them enough. This has zip to do with Obamacare
and everything to do with for-profit private companies trying to boost profits for their shareholders.
My Wife Julie is becoming an expert in getting them to pay what they should. We are both in good health and its still a struggle,
they count on many not having the energy to fight them or sic a lawyer on them.
I have Private insurance, nothing to do with Obamacare and they were doing this kind of thing from day 1 way back in 2000.
But one advantage I have is dual citizenship......free high quality care is an airfare away.......may the US be as blessed one day.
Pete
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Regards,
Rob M. (USAussie)
The Pedantic Mechanic
Sydney, Australia
'75 Avion - AUS - The Blue Streak TZE365V100428
'75 Avion - USA - Double Trouble TZE365V100426
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