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Woooofftt. That's bad advice and in an even worse order. There are a bunch of steps in between getting denied and just YOLOing it out of pocket. It looks lik
by stusmall 3y ago
Woooofftt. That's bad advice and in an even worse order. There are a bunch of steps in between getting denied and just YOLOing it out of pocket. It looks like going through the insurance company's peer to peer process is probably going to work out. It is still a bit up in the air but its looking positive. We'd already started down the route of getting connected to lawyers in case it doesn't.
I don't think "do it out of pocket and try and claw the money out of them after the fact" was ever on our list of options. I wouldn't consider that unless the lawyers suggested it. We were looking into going overseas to have to done, which honestly its another big indictment of this system.
The point still stands about how insanely inefficient this whole system is at the macro level. The fact that lawyers are getting involved in routine medical procedures or doctors are suggesting what they know is incorrect treatment is a sign of deep inefficiencies. We aren't an outlier either. It is profitable for the insurance companies to jerk you around, fight you, try and sneak past denials were they can.
- tomrod 3y agoHave yall looked into external review? https://www.healthcare.gov/appeal-insurance-company-decision/external-review/ https://www.healthcare.gov/appeal-insurance-company-decision...
- stusmall 3y agoNo offense, I appreciate the idea, but I'm not looking for suggestions. I only posted this here as an example of how the system is failing even for people with high quality insurance.
- tomrod 3y agoAnd I appreciate your story and empathize, which is why I am ensuring both you and others reading your story remember that folks finding themselves in your situation have rights that are less commonly exercised. But I appreciate that it's a tough topic and not engage further. Good luck with it.