Author Topic: Insurance Gripe  (Read 4894 times)

lawmama

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Insurance Gripe
« on: April 26, 2010, 10:52:22 am »
I am so fed up with dealing with Aetna.  It has been 6 months since my first AN-related claim (the MRI that led to my diagnosis) and I am still fighting with Aetna to get the claims paid.  At this point, I fear that some of these bills may start to appear on my credit report.  The problem seems to be the pre-existing condition review.  For some reason, they can't comprehend that ALL of the claims from the past 6-months are related to the exact same thing.  Thus, wouldn't common sense tell us that one pre-existing condition review should cover them all?  If you are Aetna, apparently the answer is no.

Sorry for the gripe session.  Not a week goes by that I don't make at least 3-4 phone calls between the different billing offices and Aetna.  I'm already busy enough.  Maybe one day they will get them all paid.   ::)

Has anyone else had this experience?
9mm X 7mm tumor (left side), diagnosed 10-15-09
Retrosigmoid on 12-14-09 by Drs. Antonelli and Lewis (my heroes!)
Shands in Gainesville, FL
SSD, but no facial issues.  Mild tinnitus.

Kaybo

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Re: Insurance Gripe
« Reply #1 on: April 26, 2010, 11:40:34 am »
First, let me KNOCK ON WOOD!!

We have Aetna and have NEVER had any problems and think how long ago my AN was??  Truly, I have NEVER had to speak to them about paying for anything remotely related to my AN - which it basically all is!  I have talked to them about other small issues (like about well checks for my girls) and then we had a LOT of calls about my T3 surgery but that wasn't because they wouldn't pay it, it just took a while because it was a new procedure and they weren't sure how to cover it (and it was in Baltimore and I live in Texas).  I will say that I did think about this since we are about to move and how it will all go now...

Sorry this is such a pain for you!!  Hope it gets resolved soon!

K   ;D
Translab 12/95@Houston Methodist(Baylor College of Medicine)for "HUGE" tumor-no size specified
25 yrs then-14 hour surgery-stroke
12/7 Graft 1/97
Gold Weight x 5
SSD
Facial Paralysis-R(no movement or feelings in face,mouth,eye)
T3-3/08
Great life!

saralynn143

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Re: Insurance Gripe
« Reply #2 on: April 27, 2010, 09:06:06 am »
Lyn, all I can say is stick with it. This has happened to me often enough that I'm convinced that insurance companies routinely deny claims in the hopes that the insured will eventually give up and they will not have to pay.

Also keep in touch with the medical offices. They should work with you on not reporting late payments to the credit bureaus as long as you are in dispute with the insurance company.

Good luck.

Sara
MVD for hemifacial spasm 6/2/08
left side facial paresis
 12/100 facial function - 7/29/08
 46 - 11/25/08
 53 - 05/12/09
left side SSD approx. 4 weeks
 low-frequency hearing loss; 85% speech recognition 7/28/08
1.8 gram thin profile platinum eyelid weight 8/12/08
Fitted for scleral lens 5/9/13

Debbi

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Re: Insurance Gripe
« Reply #3 on: May 03, 2010, 07:03:11 pm »
All I can say is "keep at 'em" - we have Aetna and I had zero problems.  They paid for everything, no hassles - which may be due to the surgeon's staff getting everything approved ahead of time.  I've had 3 MRI's since surgery and no problems with coverage there either.  Keep pushing them and go as high up the ladder as you have to.  Also, don't hesitate to get your doctor's involved.  It's crazy to have brain surgery and then have to duke it out with insurance - hmph!

Debbi
Debbi - diagnosed March 4, 2008 
2.4 cm Right Side AN
Translab April 30, 2008 at NYU with Drs. Golfinos and Roland
SSD Right ear, Mild synkinesis and facial nerve damage
BAHA "installed" Feb 2011 by Dr. Cosetti @ NYU

http://debsanadventure.blogspot.com

Nickittynic

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Re: Insurance Gripe
« Reply #4 on: May 17, 2010, 02:34:35 am »
Ugh. :(

I hope you've gotten it straight now. I had issues with my insurance on some things, but not all. Apparently the hospital I where I was treated and my insurance notoriously don't get along. It took a long time and many phone calls, but it finally got straightened out.
I haven't looked at my credit report recently to see what it did to that, though. The hospital sent me a notification that my $47,000 surgery bill was being sent to collections (a week before Christmas, no less), and then when I called them they were like "Oh, no, you're fine. We know your insurance is the one holding it up."  ??? >:( And then insurance blaimed it on the hospital, etc etc.

Anyway, I'm just venting now. Just wanted to let you know you're not alone and I feel for you!
25 year old OBGYN nurse, wife, mother of two
5.5cm x 3.1cm left side AN removed via retrosigmoid 9/09 @ Hopkins
SSD, Tinnitus, Chronic Migraines, Facial paralysis (improving!)
Resolved - Left sided weakness, Cognitive issues
Gold weight, upper and lower punctal plugs, tarsorrhaphy

Ellenmn

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Re: Insurance Gripe
« Reply #5 on: May 17, 2010, 06:43:23 pm »
My husbands insurance is now Aetna. His claims seem to go through without a problem but it's a secondary for me and I'm having all kinds of problems with them. I have called them three times on the same claims. I even had to teach them how to read the EOB from the primary. The claims still aren't processed so I hope I don't ave to call again