Massive good news on our end!!

I haven't posted about this before, because I know there are others out there doing battle just to get their surgery approved, but now that our ordeal is over I can share! I had no trouble getting insurance approval for my surgery...we were surprised that I didn't even have to do the 6 months pre op diet or anything.  Some of you may remember me posting earlier this year that my husband was changing jobs at the end of January...my surgery date was April.  His new job didn't have insurance coverage until May, so we had to pay for COBRA.  $1400 a month to cover the four of us, but we did it so I could still get my surgery.   The week before my surgery I paid our April COBRA premium online, but didn't print the confirmation page (a decision I will never ever ever make again).  Had my surgery, no complications, everything went just fine.  Then on May 8 I got our credit card statement, and the April premium payment wasn't there.  I immediately called the COBRA service center, and they had no records of me making the April payment...and were in the process of terminating our coverage, retro to March 31.    I cried and cried.  We'd already gotten the Explanation of Benefits from BCBS, showing that they had been billed $42,000 by St V's, and paid $13,000...my share was $1286.  The service center told me I could appeal the termination, so I immediately wrote a long letter, faxing it over along with the pre determination letter from BCBS to show that I would never have let our insurance lapse. May was awful...we were waiting daily to hear on the appeal, and on June 2 we learned we had been denied.  I was numb...we were facing bankruptcy, and had no idea how we would pay the bills.  By this point, I knew that Dr Evanson hadn't been paid ($4000) nor had the anesthesiologist ($1500).  I figured I could work something out with them...it was the hospital bill we were freaked out about.  Would we owe the whole $42K? Just the $13K? What were we going to do?  So I wrote another long letter, basically begging for compassion and help.  I wasn't rude or angry, just sorrowful and honestly desperate.   IT WORKED!!! We got our letter Saturday saying that they'd received our second letter, and had reconsidered.  I had to read the letter 3 times to make sure I understood it, and this morning I called in and paid the April premium over the phone.   I am so glad this saga is pretty much over...I'll be happy once Dr E and the anesthesiologist are paid (and once I get back the $500 I already sent him)...but for now, I am no longer worried about the hospital bills and how to pay them!  Why am I posting this now? Well, while all this was going on, I wasn't posting here much at all...I had so much on my mind, and was so focused on getting past this financial hurdle, I could barely think about anything else.  I wanted to let you all know that if you are denied at first, appeal appeal appeal! Appeal the denials, and then appeal it again.  I think insurance companies expect people to give up after the first denial, but I couldn't.  I told them that in my second letter too...my dad said they probably reconsidered to prevent me from clogging their fax machine for the next year! I don't care why they did it, I'm just ecstatic that someone there finally listened to me!  Now I can start participating here again and posting!!

That is awesome Amy!! :)

Amy, I'm so glad for you that Cobra changed their minds. I'm still battling over a measley ~$200 bill from Mid-America blood lab from January. They submitted it to Anthem as 'routine'. Anthem denied it. When Anthem approves bloodwork, by the time they reduce it for what 'they allow' and after they pay their part, I'm usually left paying $5-6. But because they denied it, I being billed for the full non-reduced amount. I've talked with Anthem and they said that Mid-America needed to re-send it in with the correct codes (which is pre-surgical, due to low white count). Dr. Bergman's office has called Mid-America with the correct codes. I've faxed them, wrote them, and called them. Their latest is saying that they did send it back in and it was denied again...which is BS. Anthem sends you a statement of what-ever has been sent in, how ever many times it gets sent in. They have NOT resent it in. I know $200 isn't that much in the grand scheme of things but I don't like liars..and that's what they are now. So....I'm battleing with them. It should be about time for I think the 5th notice. Also time for yet another letter to them I guess. So...I'm VERY happy for you in Cobra's reversal because you would have had to pay the full amount for all of the medical bills associated with your surgery. Here's a great big WHEW! for you!!

Sherri