I got a letter in Tuesday's mail, exactly one week after of my recent hospitalization: Source: letter received one week after discharge swollen tongue, difficult to swallow - I had a drug allergy reaction that needed treatment before it blocked breathing heart stopped for six seconds, twice - during treatment for the allergy, my heart stopped due to previously undiagnosed heart arythmia Yes, I will call them later . . . a 'come to Jesus' call. But this is the type of "death panel" to our finances we've come to expect from private medical companies. I'm now wondering what hospital is "in network" and which physicians . . . 'Sorry doctor, you can't treat me because you are not in my insurance network.' FYI, I went to their web site and sent them a note: Source: e-mail communication Bob Wilson ps. Well one thing for sure, I've gotten more onery.
I recall that occurred to a friend who was driven to the closest hospital by an ambulance in his life and death situation. When insurance was notified they paid 100% less customary deductible. Suggest any future Dr. visits be in network
If I recall the insurance company said the closest hospital to your home was in network but the patient responded I was not home and could not talk and my friends and ambulance worker did not know my in network provider so they took me to the county hospital Just be prepared. It all worked out in the end but he says dealing with Insurance was worse than the Kidney Stone he had to pass
You, Grumpy, live in a civilized nation. Some of us here do not. Here in the US of A it is widely regarded as "communism" for the government to provide an essential service, as this would deprive private corporations of their God-given right to charge people exorbitant prices for health care, whether basic or emergency. We middle north Americans (folks living north of Mexico and south of Canada, the other north American nations) much prefer paying insurance companies 2/3 of our "health" dollars so they can maintain a bureaucracy to decide who to deny coverage to. Because a national health care system, which would cost 1/3 of what we pay now, would be "communism," or "socialism," and once you've labeled anything communism or socialism, USers would rather die of preventable disease than submit. We need universal one-payer health care, like you have. But not even our Democrats are willing to support that.
The a doctors and Hospital executive team live in the most elite zip codes. However insurance companies have legal clauses that would choke an army of lawyers all in place to deny payment based on pre existing conditions or unnecessary procedures. In America you die or go bankrupt if you get very sick. In some cases you have insurance and go to the specialist they may deny the claim because you did not see your primary Dr first. If you go out of network you may pay more
In America we provide Medicare for anyone over 65 years old for a fee which they can direct bill or deduct from social security. My mom is In her 70 's and she needs to buy private insurance to cover what Medicare dies not cover. So when we provide insurance it is inadequate . It is sad how the elite and gov have manipulated the politicians that providing healthcare is too expensive we cannot afford thus the insurance make profits like it's no bodies business
Bob, read your contract very very closely. Double check for emergency treatment rules using out of network service. (There are often state insurance mandates covering this.) The battle you want to fight (and win) is the insurance company misclassifying the nature of the treatment, not necessarily if it was in or out of network.
Well Wednesday was a good day: Checked the Anthem.com web page - sure enough, the Huntsville Hospital is in their network but the physician is not. Called their customer support and once the agent checked, sure enough, a new letter will be sent. They then said 'when your claim for the physician is denied, point out it was an emergency in your appeal' ## Oh how we LOVE our insurance company! Visited hospital with a dozen roses for the ER and heart ward staff who got a big container of mixed nuts. Heart wing staff printed off my medical records including the ER reports Included a sheet showing the admitting physician is on staff with Huntsville Hospital BTW, the records included the heart stoppage . . . how rare it is to see the record of your own heart 'pausing.' Bob Wilson
