WHAT A PAIN!!!

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karbear
karbear Member Posts: 163
edited March 2014 in Breast Cancer #1
Just wondered how many of you had to deal with insurance company problems, one after the other. I am so sick of them, I had a mastectomy two years ago and I still have one more reconstruction to go,thanks to the insurance company and their darn paperwork not being processed ,the out of network problems,getting a wig,prothesis,etc..one headache after the other..Like dealing with the cancer isn't enough..they are driving me nuts!! I am suppose to have my final reconstruction next Tues. but so far I haven't heard a word,last I heard the doctor was still fighting the insurance company, so if I do not here by tommorrow I won't be having it again..what a pain,I want to get this all behind me but its taking forever...so keep your fingers crossed for me...I'm at my wits end with the insurance company right about now!! God Bless all of you, Karin

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  • klippe
    klippe Member Posts: 7
    #2
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    No insurance problems for me, just want to leand you some sympathy and wish you luck. Dumb old insurance companies, anyway! klippe
  • jake10
    jake10 Member Posts: 202
    #3
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    Check in your state, but there are laws regarding coverage for reconstruction and to achieve symetry. Call your state dept of health and also the state insurance regulator. They should not be able to harrass you like that. The cancer is enough. I have been blessed so far with my coverage. No questions, no problems.
    Another thing came to mind. You may want to call the insurance company to see if the physician's office is complying in a timely manner with thier requests for info. Another avenue is the employer who's group you are in. They can sometimes exert pressure on the insurance company to get the ball rolling and smooth the way for you. Good Lucl!
  • rizzo15
    rizzo15 Member Posts: 153 Member
    #4
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    What a pain!! is the understatement of the year. I found out the afternoon before my mastectomy that my insurance company had not preauthorized my surgery and they were threatening not to pay. I found out later from a lawyer friend that this was an empty threat, but it's a terrible and upsetting thing to deal with in addition to the cancer. Breast cancer is my first major health problem and until now I had no idea how terrible our healthcare insurance and insurance billing system is. Maybe it's because I've worked as an executive assistant for 30+ years, but if my work and accountability were like the insurance company's, I would have been fired after the first day. Nobody takes any responsibility for anything. They ask me for the same documents a half dozen times in the same month. They threaten to close their evaluation of a claim with one letter...and have already paid the entire claim plus $40-$50 more than the total bill with another letter dated two days earlier. My insurance companies are so messed up right now, they have paid way too much for everything thus far, but it could have easily gone the other direction--them paying way too little. What can I say, Karbear? If your insurance is through your employer, sometimes your HR rep. can threaten them into submission. But, if you don't work for a big company, even that doesn't work. I know this sounds like a royal pain in the neck, but sometimes the only way to get action is to talk to somebody face to face if possible. It is too easy for the insurance company to hang up the phone and forget about you. Lots of times they don't even take notes on what you say. It's a lot harder for them to deal with a real person, with a real problem, standing right in front of them.
  • cammie
    cammie Member Posts: 102
    #5
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    I know insurance companies. I worked for a health care center, and the ins and outs are crazy for them as well as us. During my treatment my husband got laid off due to not being there. We took on my insurance and had a lot of papers to transfer, then my boss fired me due to the fact of not being there. (in the state of NH you can do that even though someone is on disability). I then had to start my husbands new insurance, but the surgery of my reconstruction was only 6 days after his started. The hospital tried to call me to tell me they didn't have approval, but I informed them of my insurance company, even though I didn't have a card yet, I was not to be a prepay and to look further. A lot of hospitals have social workers to help you through the crazy insurance companies. Please check into this. Keep calling your hospital back to get them to harrass as well as yourself and your employer. The insurance companies will not pay if they can get away with it. I know how hard it is to deal with on top of everything else. Hang in there.

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