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SVTPerformance's Chain of Restaurants
Road Side Pub
What should I do? ( Medical Related)
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<blockquote data-quote="!!!PainTrain!!!" data-source="post: 14534234" data-attributes="member: 18161"><p>I just had knee surgery. The Doctor told me she could do the procedure either at the local hospital or another private surgery center. I told her I didn't care, just make sure it's in network. I go to another woman's office to actually schedule my knee surgery. I again state, make sure it's in network. "It's in network." </p><p></p><p>Fast forward two days before my surgery, I get a phone call stating my out of pocket expense for items not covered by my insurance was going to be roughly $1300. The next day, I go to my doctors office to finalize paperwork, get my blood pressure taken and receive a pair of crutches and knee brace. I paid the 1300 bucks and off I went. At the surgery center the receptionist tells me that my insurance will probably mail the check for payment to my home. I'm supposed to endorse the check and drop it off at the surgery center.</p><p></p><p>A week after my surgery, I get a phone call from insurance stating the procedure was conducted at an out of network facility and that they are rejecting payment; I was told I now owe an additional 10,000 dollars out of pocket. I also had to produce an explanation of benefits for the 1300 charge I put on the card within 24 hours or I would owe that as well.</p><p></p><p>Now I never authorized the procedure out of network and was specifically told multiple times that it was in fact in network. So I do a little research. The doctor I had seen is part owner of the surgery center where I had my procedure. Upon multiple phone calls to said surgery center, I was told "don't worry about insurance saying you owe the bill. We accept the percentage that they payout and write off the balance. We make more money out of network with write offs than a covered procedure conducted in network. You'll get a check in the mail, just sign it and drop it off to us." </p><p></p><p>Neither office could explain or answer as to why I was lied to or how the surgery was scheduled at an out of network facility. Mind you, the in network facility it 1.6 miles down the road. Yesterday I got a letter in the mail stating insurance was not going to be sending any payment and I owe the $10,000 plus the $1,300.</p><p></p><p>I just don't see how any of this bull shit is legal. Sorry about your situation OP. At least you used your brace, my crutches never left my truck and I was billed a hefty amount for them.</p></blockquote><p></p>
[QUOTE="!!!PainTrain!!!, post: 14534234, member: 18161"] I just had knee surgery. The Doctor told me she could do the procedure either at the local hospital or another private surgery center. I told her I didn't care, just make sure it's in network. I go to another woman's office to actually schedule my knee surgery. I again state, make sure it's in network. "It's in network." Fast forward two days before my surgery, I get a phone call stating my out of pocket expense for items not covered by my insurance was going to be roughly $1300. The next day, I go to my doctors office to finalize paperwork, get my blood pressure taken and receive a pair of crutches and knee brace. I paid the 1300 bucks and off I went. At the surgery center the receptionist tells me that my insurance will probably mail the check for payment to my home. I'm supposed to endorse the check and drop it off at the surgery center. A week after my surgery, I get a phone call from insurance stating the procedure was conducted at an out of network facility and that they are rejecting payment; I was told I now owe an additional 10,000 dollars out of pocket. I also had to produce an explanation of benefits for the 1300 charge I put on the card within 24 hours or I would owe that as well. Now I never authorized the procedure out of network and was specifically told multiple times that it was in fact in network. So I do a little research. The doctor I had seen is part owner of the surgery center where I had my procedure. Upon multiple phone calls to said surgery center, I was told "don't worry about insurance saying you owe the bill. We accept the percentage that they payout and write off the balance. We make more money out of network with write offs than a covered procedure conducted in network. You'll get a check in the mail, just sign it and drop it off to us." Neither office could explain or answer as to why I was lied to or how the surgery was scheduled at an out of network facility. Mind you, the in network facility it 1.6 miles down the road. Yesterday I got a letter in the mail stating insurance was not going to be sending any payment and I owe the $10,000 plus the $1,300. I just don't see how any of this bull shit is legal. Sorry about your situation OP. At least you used your brace, my crutches never left my truck and I was billed a hefty amount for them. [/QUOTE]
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SVTPerformance's Chain of Restaurants
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What should I do? ( Medical Related)
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