Happy Friday! I have my post-op appointment today.. 2 hours away from home, so I won’t be around much to moderate. I may be able to get on for an hour or so early, depending what time they show up.
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Monday Crimson Quillfeather
Tuesday ejoanna
Wednesday Pam from Calif
Thursday art ah zen
Friday FloridaSNMOM
Saturday FloridaSNDad
Sunday loggersbrat
Has anyone else been having excess trouble this year with insurance companies trying to deny claims?
I have Medicaid in Florida. The company I used to have left the state, so I was assigned to a new one in January. Since then I’ve had nothing but trouble with them trying to deny *everything*… down to one of my asthma inhalers.
I had to fight to get them to pay for my Spireva. It’s one of two maintenance inhalers I need. Without it, my lung function plummets and I end up in a COPD exacerbation. That was the first blow. I did get them to pay for it, but I went without the Spireva for about 3 weeks in the process. That was part of the reason I ended up in the hospital in February… for two weeks.
Then there’s all the little ones, denying this doctor’s appointment, that hospital stay… and over the stupidest thing. “You didn’t need IV antibiotics so we’re not paying for your inpatient stay”. I was hospitalized for a COPD exacerbation, and my blood work was coming up as having sepsis and the x-ray showed pneumonia. But you know, what did I need to be in the hospital for? I only couldn’t breathe….
We’re not paying for your doctor’s visit because they charged for ‘surgery’. Maybe that was a coding error, but if so it’s a common coding error, I’ve received that notification about 8 times this year.
This time, before I went in the hospital, after not keeping ANY food OR drink, not even water in for 4 days, I called the ‘call a nurse’ number on my insurance card. The nurse told me to get to the ER stat. And I had to have emergency surgery, because of a hernia and a lower bowel obstruction. The doctor told me if I’d waited another day there’s a good chance I could have had part of my bowel die and I would have needed more extensive surgery and probably a colostomy. I was admitted for 2 nights. The first night because I arrived at the hospital with the surgeon around 11:30 pm (I was transferred to a hospital two hours away) and they weren’t doing the surgery until the next day. The next night as recovery as they monitored my condition and made sure things were moving well again. I went home the day after the surgery. So not an extensive in patient stay by any means.
A few days after I got home from the hospital I get a letter from the insurance company saying they aren’t paying for the in-patient stay because I “wasn’t dehydrated enough to need IV fluids”. Nothing about the surgery, or anything, just dehydration. For the record, I’m still having trouble with my lips being cracked and bleeding from the dehydration. I have dry flaking skin from it too. I didn’t keep anything in for 4 days until they inserted the NG tube (for suction because the weight of the fluids in my stomach was cutting off the blood supply to my intestines) and started me on IV fluids. But you know, I wasn’t dehydrated or anything. And dehydration wasn’t even the REASON for the admission.
They have a number to call to contest it. I’m considering calling on Monday. I’m hoping the hospital contests it. Because this is BS. I don’t know if switching insurances in November when that options rolls around will fix anything. I suspect this is just a Florida Medicaid thing. I don’t have the energy to fight every single doctor’s visit I need, especially when they give such stupid reasons.
So does anyone know, do the hospitals/doctor’s offices fight this crap, or do I need to do it? I’m not getting stuck with this hospital bill. I’m hoping they pay for the post-op appointment I’m going to today. But I’ll probably get a letter in a couple of weeks claiming something was wrong and they won’t pay it.
We need medicare for all.