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Should probably have gone to an ER. Emergencies are easier to argue and appeal. "Urgent" (yet less costly) and they assume you still could have waited... it was
by jrs235 5y ago
Should probably have gone to an ER. Emergencies are easier to argue and appeal. "Urgent" (yet less costly) and they assume you still could have waited... it wasn't an emergency yet. I hate our insurance/medical payment/determination system. It's a joke.
- vinceguidry 5y agoI went to an in-network urgent care for a particularly painful pinched nerve and got worthless drugs, and the uncovered part of the bill came out more than the covered part. Next time I'll just suffer at home and hope I don't die. It'll amount to the same result.
- Workaccount2 5y agoGiven the location and possible severity, the only viable way to an emergency room might have been a helicopter. Which insurance almost certainly would not cover. So the insurance is saying "If you paid $80,000 for a medevac, we would have covered your hospital bill".
- FireBeyond 5y agoHell, a few years ago UHC made the news because they were denying coverage for Flight EMS from serious car accidents due to "lack of pre-authorization".
- ceejayoz 5y agoThey're looking at clamping down on that, too. https://arstechnica.com/science/2021/06/biggest-health-insurer-plans-to-deny-er-bills-if-it-doubts-you-had-an-emergency/ https://arstechnica.com/science/2021/06/biggest-health-insur... > Doctors and hospitals are condemning plans by UnitedHealthcare—the country’s largest health insurance company—to retroactively deny emergency medical care coverage to members if UHC decides the reason for the emergency medical care wasn’t actually an emergency.
- sidewndr46 5y agoThis was my experience as well. I went to the ER with tremendous chest pain, it turns out I have some issue with my ribcage. Not my heart. UHC decided I did not in fact need to see a cardiologist or an ECG since I wasn't having a heart attack and declined to pay for anything. Multiple attempts on my part to resolve this yielded nothing. I contacted the state of TX, who brought suit against both parties (insurance & service provider). Somehow, the day before the court appearance they all agreed to settle the claim at no cost to me.
- yellow_lead 5y agoGood on you for being persistent.
- bradstewart 5y agoPerhaps unsurprisingly, I do indeed have United Healthcare.
- vitaflo 5y ago>Should probably have gone to an ER. Emergencies are easier to argue and appeal. ER visits for emergencies are also covered as in-network care under the ACA, even if you're half way across the country. I know cuz I was 1500 miles into a road trip when I went to the ER. My insurance covered it as in-network.
- bradstewart 5y agoThe nearest ER was still much, much farther away than the urgent care facility. I would have undoubtedly put myself at more risk by trying to drive a vehicle down a highway for an hour. Thankfully the bill I did receive was somewhat reasonable, and I was able to pay it without much issue.