Posted: 6/14/2005 1:44:48 PM EDT
 After having shoulder surgery, I find out insurance will pay for 95% of the surgery expense but won't pay for the MRIs. Now figure this out, they will pay for the surgery if an MRI shows suffecient information to warrant the surgery but now won't pay for the MRI!!!!!And my cost is more than the insurance has to pay. They negotiate a cheaper price but because they won't cover it, I am obligated to pay the FULL price which is about 2.5 x more than what insurance pays. 
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Part of the problem is the paper work. Seems like something wasn't filed the way the insurance wanted it. Supposedly it will be straightened out after talking to clerical workers for the provider and the insurance. It is on hold for the moment! In the past with coinsurance between two different insurance companies, I have had the same bill paid TWICE to the provider. Mistakes happen but the damn paper trail required by the parties involved is a quagmire. Trying to sort it out is a nightmare. Supposedly it has gotten "easier" but you can't prove it by me. |
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My company won't pay either. Sorry ass suckers. Still getting bills from my family doctor. That set me up for surgery. Bummer dudes and really a bunch of butt holes. Keep on calling and always the same doctor did not submit right papper work. This has been going on for months. Afraid to show my face at the office 
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Insurance is Aetna POS -( point of service  )- and it is being fixed supposedly. No way am I going to pay the full charge above what the discounted insurance rate is.At the first of the year, Aetna fell behind on renewing the authorizations for perscription renewal. So as a result, I paid full price of $135 every month for 3 months until the authorization were finally approved. Big difference from $10 copay! After they sent me the check for the times I paid, it was about $75 short. I asked what the hell the difference was. It was their discounted price from the pharmacy. I went to the pharmacy asking for my refund - no such luck. Called the insurance and asked for the difference - they tell me go to the pharmacy. F*ck both of them! Eckerds no longer gets my business and the Aetna people have me ear marked "beware" when I call. The provider or the insurance foul up and you get hung while they straighten it out. |