Please register to participate in our discussions with 2 million other members - it's free and quick! Some forums can only be seen by registered members. After you create your account, you'll be able to customize options and access all our 15,000 new posts/day with fewer ads.
I'm having the same issue with United Health Care. I went to the ER for abdominal pain and nausea and had an ultrasound which showed inflammation of the gallbladder. They advised me I could be admitted to the hospital and have my gallbladder removed the next morning or go home and schedule a surgery appointment. I was in so much pain and when the clock hit 4am I said check me in and cut this thing out. The next day in late afternoon I had a a laparoscopic cholecystectomy and since the surgery ended late they kept me overnight in the hospital. I was discharged the next day and found a letter from UNC that they were denying my claim for the inpatient services because they deemed all gallbladder removal to be an outpatient service. I'm calling them tomorrow, but I'm getting a little uneasy about my 45K hospital bill which so far only 3K is being approved.
I'm having the same issue with United Health Care. I went to the ER for abdominal pain and nausea and had an ultrasound which showed inflammation of the gallbladder. They advised me I could be admitted to the hospital and have my gallbladder removed the next morning or go home and schedule a surgery appointment. I was in so much pain and when the clock hit 4am I said check me in and cut this thing out. The next day in late afternoon I had a a laparoscopic cholecystectomy and since the surgery ended late they kept me overnight in the hospital. I was discharged the next day and found a letter from UNC that they were denying my claim for the inpatient services because they deemed all gallbladder removal to be an outpatient service. I'm calling them tomorrow, but I'm getting a little uneasy about my 45K hospital bill which so far only 3K is being approved.
Just curious - is yours an individual policy, or are you insured through your employer? Son/dil are insured by a UHC large-group employer (not self-insured) policy and haven't had any issues with UHC paying. Whenever he mentions UHC, I cringe but, so far, UHC has come through for the two hospitalizations he's had - both as a result of a visit to the ER. In one case, he stayed over a week, the other four days. I tend to attribute lack of payment issues, perhaps wrongly, to the fact UHC doesn't play games with employer group policies, as UHC can pull off this denial/nonpayment crap so much more easily with an individual, imo. I will say, though, your hospital should have called UHC for preapproval. Most hospitals do that.
Just curious - is yours an individual policy, or are you insured through your employer? Son/dil are insured by a UHC large-group employer (not self-insured) policy and haven't had any issues with UHC paying. Whenever he mentions UHC, I cringe but, so far, UHC has come through for the two hospitalizations he's had - both as a result of a visit to the ER. In one case, he stayed over a week, the other four days. I tend to attribute lack of payment issues, perhaps wrongly, to the fact UHC doesn't play games with employer group policies, as UHC can pull off this denial/nonpayment crap so much more easily with an individual, imo. I will say, though, your hospital should have called UHC for preapproval. Most hospitals do that.
Mine is through my employer. Big global telecommunications company. Been insured by same plan fo going on 20 years and in the last couple they have decided to play a lot of games. They really used to stick it to me when my autistic son used to go to an occupational therapy place. Getting claims approved was like pulling teeth.
Mine is through my employer. Big global telecommunications company. Been insured by same plan fo going on 20 years and in the last couple they have decided to play a lot of games. They really used to stick it to me when my autistic son used to go to an occupational therapy place. Getting claims approved was like pulling teeth.
Sorry to hear that. Par for the course with UHC from what we hear. Some of the other bigger insurers are also more difficult, but UHC appears to be the worst - or maybe it's because UHC has a larger share of the market so, naturally, there would be more complaints. When I worked (until 2009), I made very few claims. Few times I did, plan paid as expected. My employer was self-insured w/Aetna as an administrator. A coworker's husband had a kidney transplant which Aetna balked at 'paying' - $250k - she was beside herself, talking bankruptcy. I think she complained to a few of the head honchos at our place (we were in the main office and knew everyone pretty well and she had been there a LONG time), and eventually the claim was approved. Not sure what finally got it done or why there was a problem in the first place, because Aetna had also assigned a caseworker to them prior to the surgery. Anyway, squeaky wheel. It's a shame people need to jump through these hoops. Kinda' defeats the meaning of the word "insurance."
Sounds to me, just wait and see what bills you get. They can't get blood from a turnip and if need be set up a monthly payment schedule..$10/mo say. Someone goofed sounds like to me.
I learned the hard way that today hospital don't except 10.00 a month any more, found that out the hard way they will turn it over to a collection agency and garnish wages,
once apon a time you could give a dr or whom ever something a month and they couldlnt do anything about it. not that way anymore.
I learned the hard way that today hospital don't except 10.00 a month any more, found that out the hard way they will turn it over to a collection agency and garnish wages,
once apon a time you could give a dr or whom ever something a month and they couldlnt do anything about it. not that way anymore.
Yeah not many people like getting their paycheck at $10 a month.
In case anyone has lost sleep wondering how this all worked out, I thought I'd give a quick update.
Got a bill this week from the hospital for a little over $21K. At first I was relieved because $21K is a lot better than $46K. Then I remembered I don't have $21K either. I checked on Aetna's site to see if the hospital had filed any new/updated claims, and Aetna was showing that they had and that I would owe around $700. Called the hospital and the first thing the customer service rep said was that they had sent me a bill before receiving my insurer's payment and that I only owed the $700. Paid it. Inhale, exhale. So glad that's over with.
The bill I received from the hospital had $46K worth of charges, but $25K was subtracted as an "HMO Allowance." The hospital sent Aetna a bill for $41K. Aetna said my member rate was $7K of which they paid $6300 and I paid the $700 coinsurance.
Please register to post and access all features of our very popular forum. It is free and quick. Over $68,000 in prizes has already been given out to active posters on our forum. Additional giveaways are planned.
Detailed information about all U.S. cities, counties, and zip codes on our site: City-data.com.
Please register to participate in our discussions with 2 million other members - it's free and quick! Some forums can only be seen by registered members. After you create your account, you'll be able to customize options and access all our 15,000 new posts/day with fewer ads.
