Musing on food and cooking ...

Monday, January 07, 2008

Yours Truly Really Is Going to Have a Stroke Now

So as some of you dear readers now, I have been having some health concerns lately, bad enough that I actually went to the doctor, something I almost never do. I was having numbess in my face and in my fingers and I was dizzy. I had also been battling a really awful probably sinus infection/sinus pain that I just couldn't shake off. I get to the doc's office and she is very concerned about the numbness and the dizziness, fearful that I have had a mini-stroke, not at all an unreasonable diagnoses considering my family history and the amount of professional stress I have been under lately. So she orders a gazillion blood tests, an echocardiogram, and a brain MRI, which - in her words - is the most conservative course of treatment. So she faxes off the referral form to the hospital, gives me a copy, and sends me off for a prescription for a major antibiotic and super hydrocortizone cream to deal with the hives the antibiotics are going to cause (I get hives from antibiotics). I call the hospital and get scheduled, thinking everything is just great.

Last week I got a notice from the hospital saying I was going to have to pay 20% of my MRI bill, or almost $800. I was freaked. But I can see finding a way to pay that off in a year.

Today, I got a notice from my health insurance that has me in a total panic. Someone somewhere did not tell the insurance company that they had referred me for an MRI and the insurance company is refusing to pay any of it. Not one dime of the $3500.

So I called my doctor to find out what the deal was, and I am waiting to hear back. Her MA had never heard of such a thing. Obviously, the hospital also did not contact the insurance company, although they had a copy of the referral form a week before the tests. And I am afeared I am about to get caught in between the evil medical red tape machines. I will, of course, file an appeal, but I hear from my coworkers that appealing to United Healthcare is like peeing into a wind storm. So I fully expect to be screwed. If so, please be prepared to attend at least one of Heather's Heinous Health benefits, donation in hand...


Little Merry Sunshine said...

I have faith that it will all work out. 10 years ago (or so), I had a medical emergency while on vacation, in super-remote Northern Michigan, on a Sunday. I had to be rushed to the hospital ER. I honesetly don't remember if we tried to call the insurance company or not, but I think so and couldn't reach anyone. A medical emergency is a medical emergency, so off we went. I was treated and fine and even went home (to our vacation spot) later that day, although my family vacation along with my dad's, was ruined due to the daily 2-hr round trip drives for outpatient treatment for the duration of my trip.

Bright and early Monday morning, I did get through to the insurance company and explained the situation. I was assured that everything would be fine and that despite being outside my network, everything would be taken care of AND that I had permission to continue with the prescribed treatments.

I returned from my vacation, saw the specialists I needed to in order to continue my treatment (all with the consent of my insurance company), and 6 weeks or so later started getting bills from every doctor I'd seen or who had walked through the hospital while I was there.

I immediately called my insurance company and was given that spiel about being outside the network and not calling first. Blah blah blah. Finally, I got some really sympathetic woman on the phone and she agreed that an emergency is an emergency and they covered everything.

The key was my persistence. I have faith you'll get the bad insurance company to see things your way. :)

Jenn said...

I really hope they are just idiots and somehow the referral didn't connect.

Be persistent and yell a lot to many different people. It works.


jenn said...

I have faith too -- United Healthcare will figure it out. You might have to have some annoying phone calls, though. I have a can of beets if you need some food. :)