insurance question

Hey gang —

I have an astronomical anesthesiology bill from Elliot’s birth. I’m about to call my insurance company to ask what gives, and I suspect what I’ll hear is that the doctor (who I had no hand in choosing) is out of network. Anyone have any advice on how to push back on that?

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14 responses to this post.

  1. Offer to send them Elliot to raise?

    Reply

  2. Offer to send them Elliot to raise?

    Reply

  3. Appeal, appeal, appeal.

    Reply

  4. Appeal, appeal, appeal.

    Reply

    • I know how naive this sounds:
      How do I appeal? When I call the rep will say, “Let me check and see if there’s anything we can do.” Then she’ll come back and say, “I’m sorry, there’s nothing that can be done.” On what basis do I appeal?

      Reply

      • Lynn just went through the process of appealing something with her hip surgery and was successful.
        Your HR contact at your company should be a good starting place.

      • Yes, go to HR at your company, because they will have an insurance liason. There WILL be a time limit on your appeal, and they’ll likely withhold their denial until after your appeal date is past, thinking you won’t appeal again. Do.
        There’s also something where you can ask the provider to only charge you the Medicare rate? I think–ask about that.

      • You say, very nicely, “Thank you so much for your help. I appreciate your time. May I speak with your supervisor please?” And then you ask that person how to initiate the appeals process. You’ll have to fill out some forms and write some letters, and you’ll have to keep telling them over and over that you did not choose your physicians and whomever else you didn’t choose, but you certainly would have, had you been in any condition to do so.

  5. I know how naive this sounds:
    How do I appeal? When I call the rep will say, “Let me check and see if there’s anything we can do.” Then she’ll come back and say, “I’m sorry, there’s nothing that can be done.” On what basis do I appeal?

    Reply

  6. Lynn just went through the process of appealing something with her hip surgery and was successful.
    Your HR contact at your company should be a good starting place.

    Reply

  7. You say, very nicely, “Thank you so much for your help. I appreciate your time. May I speak with your supervisor please?” And then you ask that person how to initiate the appeals process. You’ll have to fill out some forms and write some letters, and you’ll have to keep telling them over and over that you did not choose your physicians and whomever else you didn’t choose, but you certainly would have, had you been in any condition to do so.

    Reply

  8. Yes, go to HR at your company, because they will have an insurance liason. There WILL be a time limit on your appeal, and they’ll likely withhold their denial until after your appeal date is past, thinking you won’t appeal again. Do.
    There’s also something where you can ask the provider to only charge you the Medicare rate? I think–ask about that.

    Reply

  9. Don’t give up. The insurance company will sandbag your efforts to delay paying as long as possible. Just keep fighting them.

    Reply

  10. Don’t give up. The insurance company will sandbag your efforts to delay paying as long as possible. Just keep fighting them.

    Reply

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