Vent: Insurance, hospitals, doctors, etc

I went in for a "Cat scan with brain lab" today in preparation for my sinus surgery next week.

I get there and the hospital is having issues with the brain lab, I hear them talking behind the counter and them saying that insurance only authorized a cat scan, not brain lab. I hear one of the ladies at the desk say "Well, she's only approved for a cat scan, so just give her a cat scan" so they call me back. I question the tech about it - ok thats all nice and good but I need the brain lab too (whatever a brain lab is, anyway..) and he tells me "well, your doctor didnt get approval for it, and you need a new prescription". I question him on it, considering my script specifically says "brain lab". He has no response. He tells me that the test is 4K so we need to make sure I have approval for it. I ask if they called my doctor, he said they werent open yet (but they open at 7AM, so I know that was a line of BS).

So I walk out after the catscan only, call the dr's office (they pick up on the second ring, thank you very much) and she tells me they have everything wrong. I hand the phone over to the people at the desk and they fight back and forth on the phone, and the doctor needs to call billing, blah blah blah. I sit and wait - 25 minutes later they say "Our supervisor told us to go ahead with it." So they gave me my test.

I called back the Drs office after I left and she said they were all confused and she spoke to the billing supervisor. I ask her if it should be covered by insurance and she said "should be". She said they do this every week so she is not sure why this is causing a problem.

All I have to say is it's a good thing I'm nosey and have good hearing. If I didn't hear the nurses talking behind the desk I would have NO clue what's going on. I wouldn't have known that they only gave me half the test I needed. They should have told me what was going on, but they didn't.

I was thinking of calling the insurance company, but I have NO idea what I would say.

So now I wait - I guess if I don't get a $4K bill in 2 or 3 months I'm in the clear. All this does is add to pre-surgery jitters and stress.

Re: Vent: Insurance, hospitals, doctors, etc

I had the same thing happen to me with my mammo. I get a 6 month mammo but they wouldn't do it because my last one was normal. Hellooooooo, I have history of abnormal findings and had surgery for it. Not your place to question the reason..the doc gave a script..do it.

They wouldn't do it. They called my reg doc who gave them the script and they wanted him to authorize it and he told them to call my breast doc.

No, that's not the procedure. I have a script, you do the procedure and my insurance company pays. If they don't pay, you send me a bill. That's how life works. I sign my life away for financial responsibility for you..do the procedure.

My breast doc is useless..they don't call me back..they are fired too.

Message edited 3/4/2009 10:53:53 AM.

Re: Vent: Insurance, hospitals, doctors, etc

Exactly.

If there is a problem, that's fine. Just tell me there's a problem. If I wasn't sitting right next to the nurses window, I never would have known. I would have left this morning thinking that everything was A-OK. I'm guessing they would have found out the day before or day of the surgery I was missing tests, and then well, I guess I would end up being rescheduled...