Ever Have Your Insurance Deny Payment For Treatment In The Hospital? - Sitcoms Online Message Boards

Family Ties Forever! · 09-04-2010, 05:04 PM

Has anyone had to fight a bill from their insurance regarding a hospital stay?

I received a letter today from my insurance denying payment for antibiotics I received in the hosptial as a result of complications during my first surgery (ERCP). The common bile duct was prefreated[spelling?] (a hole was caused) when a large gall stone was removed from it. I had to have a stent put in as a result and given antiboitics prior to my second surgery which was the gall bladder removal.

The insurance doesn't want to pay for that. Since they will be closed Monday, I will have to call Tuesday and fight with them over it. I had to have two emergency surgeries, it's not like it was elective.

phoebe7165 · 09-04-2010, 05:36 PM

Not so much for a hospital stay, because I've never had to stay in a hospital, but it was for a procedure. I was having heart problems and the doctor wanted me to get an "echo". I get a bill later for $1200!! I didn't bother fighting it because I figure I would lose this one. Little ole me against a big bad insurance company?? The doctor's office let me pay $50 a month to pay it off. If I knew I would have to pay for that, I don't think I would've gotten it done, even if I was having heart problems. It's pretty sad that I would have to choose to not to get a procedure to see if there was anything wrong with me because it costs so much!!

How much was your bill, BTW?

ZeldaGilroy · 09-04-2010, 08:37 PM

When I had gallbladder surgery a few years ago my insurance refused to pay for the anesthesioslogist used. I have a bad reaction to anesthesia, and they had to monitor throughout the operation and give me smaller doses throughout, so the anesthesiologist was "on call" more than he would have been in a typical surgery. The insurance said they didn't approve it, so they would not pay for it. It cost me $1200 for that alone, not to mention my co-pay. All together, it was a pretty hefty bill!

I hope you get yours worked out!

Family Ties Forever! · 09-05-2010, 03:33 AM

Quote:

Originally Posted by phoebe7165

Not so much for a hospital stay, because I've never had to stay in a hospital, but it was for a procedure. I was having heart problems and the doctor wanted me to get an "echo". I get a bill later for $1200!! I didn't bother fighting it because I figure I would lose this one. Little ole me against a big bad insurance company?? The doctor's office let me pay $50 a month to pay it off. If I knew I would have to pay for that, I don't think I would've gotten it done, even if I was having heart problems. It's pretty sad that I would have to choose to not to get a procedure to see if there was anything wrong with me because it costs so much!!

How much was your bill, BTW?

It says it's not a bill, but "an explanation of Benets, denial of payment." "[insurance company] has denied payment for a service that you received." "Documention of order for prophyLactac parenteral antibiotics to be given within" "Not a covered service."

Family Ties Forever! · 10-27-2010, 10:49 PM

I received a second denial letter from my insurance company two days ago. They tried denying payment for a medication I was given in September when I had the stent removed. I don't understand why they didn't want to pay for an antibotici the first time in August and then pain medicine in September on the day I had the stent removed.

09-04-2010, 05:04 PM	#1
Family Ties Forever! Member Forum Fanatic Join Date: Apr 16, 2002 Location: Keaton residence Posts: 10,214	Ever Have Your Insurance Deny Payment For Treatment In The Hospital? Has anyone had to fight a bill from their insurance regarding a hospital stay? I received a letter today from my insurance denying payment for antibiotics I received in the hosptial as a result of complications during my first surgery (ERCP). The common bile duct was prefreated[spelling?] (a hole was caused) when a large gall stone was removed from it. I had to have a stent put in as a result and given antiboitics prior to my second surgery which was the gall bladder removal. The insurance doesn't want to pay for that. Since they will be closed Monday, I will have to call Tuesday and fight with them over it. I had to have two emergency surgeries, it's not like it was elective.
	__________________ Jenny

09-04-2010, 05:36 PM	#2
phoebe7165 Pop Culture Goddess Forum Fanatic Join Date: Apr 15, 2003 Location: US of A - the country of "really bad music" lovers Posts: 11,600	Not so much for a hospital stay, because I've never had to stay in a hospital, but it was for a procedure. I was having heart problems and the doctor wanted me to get an "echo". I get a bill later for $1200!! I didn't bother fighting it because I figure I would lose this one. Little ole me against a big bad insurance company?? The doctor's office let me pay $50 a month to pay it off. If I knew I would have to pay for that, I don't think I would've gotten it done, even if I was having heart problems. It's pretty sad that I would have to choose to not to get a procedure to see if there was anything wrong with me because it costs so much!! How much was your bill, BTW?
	__________________ Rest in Peace to my Penny-pie. You really were a GREAT dog. I'll see you at the Rainbow Bridge. Penny 9/1/97-12/9/09 Rescued animals make the best pets. Opt to Adopt!!

09-04-2010, 08:37 PM	#3
ZeldaGilroy Dobie and Zelda Forever!!! Forum 4000 Club Member Join Date: Nov 14, 2000 Location: I don't know...I'm probably lost! Posts: 4,144	When I had gallbladder surgery a few years ago my insurance refused to pay for the anesthesioslogist used. I have a bad reaction to anesthesia, and they had to monitor throughout the operation and give me smaller doses throughout, so the anesthesiologist was "on call" more than he would have been in a typical surgery. The insurance said they didn't approve it, so they would not pay for it. It cost me $1200 for that alone, not to mention my co-pay. All together, it was a pretty hefty bill! I hope you get yours worked out!
	__________________ *Formerly FactsFan* "I always carry a spare wedding ring. A single girl never knows when lightning may strike." ~Zelda Gilroy

10-27-2010, 10:49 PM	#5
Family Ties Forever! Member Forum Fanatic Join Date: Apr 16, 2002 Location: Keaton residence Posts: 10,214	I received a second denial letter from my insurance company two days ago. They tried denying payment for a medication I was given in September when I had the stent removed. I don't understand why they didn't want to pay for an antibotici the first time in August and then pain medicine in September on the day I had the stent removed.