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Posted: 1/26/2006 8:35:46 PM EDT
[Last Edit: 1/26/2006 8:52:36 PM EDT by thebeekeeper1]
I was supposed to have a disc replacement surgery in July due to a herniated disc I have been dealing with for 5 years. Then the insurance company got involved and said the disc replacement surgery was not a proven fix for my problem so they wouldn't approve it.

Now I also have a condition called winged scapula which is caused by damage to the long thoracic nerve. I have been to 3 orthopeadic surgeons, all of which are pretty stumped as far as how to treat it. I have also been to a local Neurologist and his response was "sorry, I can't help you". Now I have found a specialist in Houston that has great success with this sort of thing by de-compressing the nerve and regaining mobility and strenth to the paralized muscles in the shoulder. So I had it all set up to go see this doctor and he is not in the network, the insurance company will not work with the doctor to negotiate a discounted rate so the doctor says I have to pay $5000 on the day of surgery plus the normal 20% and the hospital fees as well.

What a fucking ripoff.

Did I say I HATE insurance companies?


<Edit to remove F-word from thread title. --tbk1>
Link Posted: 1/26/2006 8:42:22 PM EDT
Insurance companies are the largest holder of bonds in the US. They are a pretty critical part of our economy – but yes they will fuck you at every opportunity.
Link Posted: 1/26/2006 8:46:53 PM EDT
Have you thought about consulting a lawyer? There is a business here that advertises on the radio. They play hardball with insurance companies when they balk at adequate payment. Of course they recommend hiring them out of hand at every opportunity in the ads. In your case it seems like such a service might actually be needed.

Galland
Link Posted: 1/26/2006 8:48:12 PM EDT
YOU NEED THE TEXAS HAMMER! (is that Jim Adler or a different one?)
Link Posted: 1/26/2006 8:50:16 PM EDT
Imagine how expensive health insurance would be if they paid all of the legitimate claims! We could never afford it. Well, that's what our Blue Cross agent said in their defense when I went by his office to tell him we were canceling their coverage after they denied every single claim at work over a four year period.

Just after we switched to Golden Rule, the local hospital stopped taking it, so we're in even worse shape now. Yes, health insurance is nearly useless.z
Link Posted: 1/26/2006 8:50:25 PM EDT
Why not the Hebrew Hammer? Oh yes, he is getting ready to lay the whoop ass in Palestine...
Link Posted: 1/27/2006 4:15:46 AM EDT

Originally Posted By zoom:
Imagine how expensive health insurance would be if they paid all of the legitimate claims! We could never afford it. Well, that's what our Blue Cross agent said in their defense when I went by his office to tell him we were canceling their coverage after they denied every single claim at work over a four year period.

Just after we switched to Golden Rule, the local hospital stopped taking it, so we're in even worse shape now. Yes, health insurance is nearly useless.z



Golden Rule has been bought by United, so the provider networks should be larger, if anything. Not that any insurance co. is "good", but I'm surprised that a former GR hospital is out of the picture as far as the "new" corporate arrangement is concerned. Call GR.
Link Posted: 1/27/2006 4:19:29 AM EDT
Maybe you could go to Canada to have the operation performed.


Sorry, don't mean to make light of your situation. In Canada, health care is free, but completely worthless. In America, health care is the best in the world, but unaffordable. At least here you have the option of paying for it. There, it is illegal to do fee for service health care.
Link Posted: 1/27/2006 4:24:18 AM EDT
Link Posted: 1/27/2006 6:02:38 AM EDT

I'm surprised that a former GR hospital is out of the picture

I wrote that "the local hospital stopped taking it." Golden Rule owes the hospital a tremendous amount of money and refuses to pay. From reading the comments from the CEO in the local paper, they're never going to do business with Golden Rule again unless something drastic changes.z
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