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Komodo'd Again! :-(

Komodo May 16, 2012

  1. Komodo

    Komodo entertainment coordinator Brigade Member

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    For the past few months I've been going through the process of getting ready to have my gall bladder removed. I've had to go to lots of doctors, get lots of test, before I could go to the actual surgeon to make arrangements for the surgery.
    I've also had to deal with my insurance company. :ssad:

    If I use an "in-network" doctor I'm golden, they pay 100%. If I use OUT of net-work, they only pay 10%!!! I made SURE to use only IN network.
    Or so I thought!!!!!!:devilzeek

    The doc who did the endoscopy is IN network. I made SURE before we went ahead. Unfortunately for me, HE was the only one in network. His office where they did it, his staff, and his lab, are all OUT of network.
    I got a bill for roughly $10,000 :devilzeek (I'm in the process of fighting this one)

    Yesterday, I finally got to see the surgeon. When I first called for the appointment I asked about insurance. He is NOT in network, BUT, he agreed to accept whatever my insurance will pay as payment in full.
    I get to his office, sign in, and there's a BIG sign on the wall. The hospital requires an "assistant" surgeon, of THEIR choice, to be present for all surgeries.
    When I see the surgeon I ask him about this. He assures me that HE will do ALL the work from start to finish, and the "assistant" does absolutely nothing. Then I ask him if HE pays this guy. NO, I have to. Will he accept my insurance? NO, he doesn't take any insurance!
    This is fucking BULLSHIT!
    He agrees it's bullshit, but his hands are tied and HE has no choice.
    I ask about the rest of the staff who'll be in the OR and he tells me to check with the hospital because he has no control over who's there, or IF they accept insurance!!!

    We get through all that bullshit, and get ready to set a date for the operation. BEFORE he can give me a date.....I have to go and get medical clearance from my: Cardioligst, Pulmonoligist, Primary Doctor, AND the hospital!!! There is nothing wrong with me! I already GOT clearance a month ago for the fucking Endoscopy!!!!
    He agrees it's more bullshit, but regulations require clearance no more than 15 days before surgery.

    With all this BULLSHIT involved, it's no wonder our health insurance costs a fuckin' fortune! :pissedevil:
     
  2. LurtzWV-6

    LurtzWV-6 ZOOM-SMASH-WHOOSH Lady Devil

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    I've always wondered where the hospitals/doctors/ect. get off on charging the prices that they do. Eight-hundred dollars for an ambulance ride from one hospital to the next, really? :devilzeek

    I feel for you. I hope things get resolved well.
     
  3. Stabber

    Stabber Stabber's Steel Connection Knife Maker or Craftsman

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    They have some Gall!!
     
    LurtzWV-6 likes this.
  4. EOD13

    EOD13 Balisong Addict JDBA Official Member

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    Man that is just insane.... 10 grand out of pocket :ross:

    Hope you get it resolved! Think of all the shiny knives you could buy with that :thumbsup:
     
  5. markandrex

    markandrex Thunderstruck Brigade Member

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    It always amazes me when we get statements about coverage and the difference between the original charge and what the insurance company pays that is accepted.:devilzeek
    It seems that those without coverage are charged the most.
    My wife had her's removed last year. Out-patient, recovered for the weekend and back to work on Monday. Even with excellent coverage we were out-of-pocket about 2k.
    I hope your surgery goes as well.
    Good luck with the insurance situation. When all i said and done, how much is your health worth?

    Take care and best to you.
     
  6. Komodo

    Komodo entertainment coordinator Brigade Member

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    $1.63

    :bwah: :bwah: :bwah: :bwah: :bwah: :bwah: :bwah: :bwah:
     
  7. Komodo

    Komodo entertainment coordinator Brigade Member

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    :ross: :ross: :ross:
    :bwah: :bwah: :bwah:
    :ross: :ross: :ross:
     
  8. Stabber

    Stabber Stabber's Steel Connection Knife Maker or Craftsman

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    :bwah:

    Come on Buddy, $1.63 in today's economy???.....:manganr:

    hope ya get this squared away:thumbsup:
     
  9. fod

    fod Hand of the Box Master Knife Maker or Craftsman

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    Really?
     
    Komodo likes this.
  10. Komodo

    Komodo entertainment coordinator Brigade Member

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    :lafflol: :bobert::bobert::bobert: :lafflol:

    HAD to send ya' some green for that one!
     
  11. AJD1

    AJD1 Prince Of Darkness Brigade Member

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    $800 for an ambulance ride???

    It better have been 1 of these Porches,at least..

    Hope you are feeling better man..

    [​IMG]
     
  12. gzb

    gzb SUPER Moderator* Super Moderator

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    Where have you been AJ?

    Believe it or not, an $800 fee for an ambulance transport is in the realm of ~average~ these days.

    Lots of variables involved (mileage, ALS/BLS treatment, etc), and the Porsche isn't one of them...
     
  13. Komodo

    Komodo entertainment coordinator Brigade Member

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    Believe it or not, we've never had to pay for an ambulance. :devilzeek

    The local Fire/Rescue Dept answers all emergency calls and there's never a charge. For non-emergency ambulance transportation, the local American Legion will take you where you need to go free of charge too. :manganr:
     
  14. KMNREMTP

    KMNREMTP Devil's Playmate

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    LOL! $800, my company would laugh n ask where the rest is??? For a 9-1-1 call, ur about 2/3 of the way there, try about $1200 on average, for a transfer your lookin more like $2Gs.

    If y'all found an ambulance for $800, be appreciative. and I'd almost bet it aint a porschebulance, although I'd like to try one of those out!
     
  15. Komodo

    Komodo entertainment coordinator Brigade Member

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    So, I saw the Cardioligist yesterday for clearance for the gall bladder surgery. I thought it was going to be a slam dunk. Go in, get yet another EKG and get my clearance.


    That's what would happen with anyone else, but not me! :pissedevil:



    The doc won't clear me unless I go get a Cardiac Stress Test. :cry:
    I hate, fuckin' HATE, that damn test! I've had it before, passed with flying colors, but wished I would have DIED during the fucking thing!

    I can't take the physical version, and need to take the drug induced version. Whoever thought up this test is one sick, twisted, Sadistic mother fucker! They should be brought up on charges of "Crimes Against Humanity", then drawn & quartered!


    I tried my best to talk the doctor out of forceing me to take this test, but he wouldn't budge. It's either take the test, or forget about getting my gall bladder taken out.


    Komodo'd yet AGAIN! :komodo:
     
  16. falcon125

    falcon125 the express train to mayhem Brigade Member

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    It is because there are laws stating that hospitals have to treat people in emergency rooms whether those people can afford it or not.
    A boat load of people exploit this law and use the emergency room as there primary care physician. these people give fake names and never have a drivers license or any other form of ID. Most of them speak spanish. But there is the trailer trash and all forms of other scum as well.

    This is the true health care crisis in America. We have the best care in the world and give it away to anyone willing to lie.
    The honest folks get the bill.

    Combine this with the fact there is 4 layers of managment between you and your doctor that expect to get paid for your misery and you can see how it has spun out of control.



    Komodo: Good Luck. My gall bladder was the most painful thing I ever went thru.
     
  17. KMNREMTP

    KMNREMTP Devil's Playmate

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    Indeed this is correct, we haul Person A, B, C, and D in a shift. Person A is a severe trauma who requires tons of interventions as well as a very long transport to a specialist. They have no insurance, no job, and no reason to pay their bill. so they dont. Person B is involved in a rather minor call, requires transport to a decent ER, and decides that they did not get the level of care that they were 'entitled' to, so they sew. and of course don't pay their bill either. Person C has insurance, STATE insurance (which pays whatever they want and force the bill-er to write Paid in Full on the rest of the bill). They have a sore throat times 3 days.... Person D is a hard working fellow with decent private insurance. The insurance pays a large portion of the bill and the individual is the one responsible for the rest of the bill. THIS bill is outrageous because Person A didn't pay, nor did Person B (who actually put the company in the red because they sewed). Person C's state insurance paid $300 on a $1000 bill, and would not allow further billing. and Person D is left paying for all of the above healthcare that has not already been paid for, as well as helping pay in the increased cost of liability insurance due to being sued by Person B.

    Health care's in a HELLUVA mess.
     
  18. mack1

    mack1 Resident Bastid

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    :devilzeek I see things are still about average for ya, John, even after all this time. :ssad:

    So, what's the prognosis these days?
     
  19. Stabber

    Stabber Stabber's Steel Connection Knife Maker or Craftsman

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    Me thinks He rode his Bicycle to his Dentist for the surgery to save Money:thumbsup:
     
  20. gzb

    gzb SUPER Moderator* Super Moderator

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    Nope. Getting his son to do the deed after Googling *Surgical Procedures*...
     

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