UPDATED! Help! Surgery is Wednesday but I just got a call saying there was a mistake with...

                    Today while cleaning my home and doing some last minute shopping before surgery Wednesday, I got a call from my hospital asking when and how I would be paying my 50% of the surgery!! I was in shock! I have been told many times by Dr's office that my BCBS paid 100% after my deductible was met.  I have all of my emails and ref. numbers from weeks ago stating that I owe nothing and that my BCBS was paying 100% of the cost.

      So I have called and so has the Specialist at my Dr's office. They all just say sorry. "Courtney" at BCBS made a mistake in saying that. You do indeed owe the first 50% cost of the surgery. That cost from the hospital alone is 8,000.00 dollars. I am heartbroken and I think I will have to cancel the surgery. I don't have that kind of cash and I sure can't make something happen before tomorrow evening since surgery is Wednesday morning.

   Does anyone have any advice for me? Anybody with the same situation? Heartbroken is the only word I have to describe this horrible feeling. I have been crying on and off all afternoon since I found out. 

        I just don't understand how I managed to slip through the cracks until now.

 Thank you in advance,

izzi

Did you call your insurance company directly? Is this doctor out of network?

   Yes, I called the insurance company today to check on my own.  They just said that the surgery was only 50% covered, and that they pay the last 50%.   They don't understand how they made the mistake...except that my insurance does pay 100% after deductible has been met except that they are excluding 50% of the WLS.

  The insurance person at my doctor's office told me how sorry she was, and that the "boss" at BCBS was looking into it, because a mistake was made by one of their people for saying the wrong thing.

     I am know sitting here thinking of the thousands I have already spent getting ready for this surgery. I took off work this coming week and bought 400.00 dollars worth of the shake stuff that i had to buy from my doctor's office. If I had known the amount I was going to have to pay out of pocket for this I would have ended this journey months ago, and tried again later when I was more secure.

 

                    Today while cleaning my home and doing some last minute shopping before surgery Wednesday, I got a call from my hospital asking when and how I would be paying my 50% of the surgery!! I was in shock! I have been told many times by Dr's office that my BCBS paid 100% after my deductible was met.  I have all of my emails and ref. numbers from weeks ago stating that I owe nothing and that my BCBS was paying 100% of the cost.

      So I have called and so has the Specialist at my Dr's office. They all just say sorry. "Courtney" at BCBS made a mistake in saying that. You do indeed owe the first 50% cost of the surgery. That cost from the hospital alone is 8,000.00 dollars. I am heartbroken and I think I will have to cancel the surgery. I don't have that kind of cash and I sure can't make something happen before tomorrow evening since surgery is Wednesday morning.

   Does anyone have any advice for me? Anybody with the same situation? Heartbroken is the only word I have to describe this horrible feeling. I have been crying on and off all afternoon since I found out. 

        I just don't understand how I managed to slip through the cracks until now.

 Thank you in advance,

izzi

UPDATE: TUESDAY at 1pm

      My day started at 8am bright and early on the phone with my insurance co. and my Dr's office. Lots of tears, and about thirty phone calls have taken place. It was decided that I was indeed looking at about 10,000-15,000 dollars in bills from the hospital and $2,000.00 from my surgeon's office. I am faced with having to pay the $2,000.00 today before 3pm if I want to keep my surgery date. 

    Also, BCBS said that they were not responsible for anything even though they did give the wrong information to my Dr's office in July.....I cried.....I begged.....I cried more, but tried to hold it together. I asked to speak to the "BOSS" and she told me the same thing, so I cried and thanked them for their time. Their point was that they (BCBS) had given the correct information to my Dr's office in March so that cancelled out the "mistake" in July thus leaving me with the first 50% of the surgery cost. I even ever so nicely mentioned contacting the State Insurance Board/Com. Nothing helped!

     I then called my Dr's office again and begged for the ability to make payments. That was a no. I then spoke with the manager and begged, and cried and begged some more. I got a very polite no, and care credit numbers and that kind of thing while the manager then tried to get me to just reschedule. I explained that there would be no rescheduling. If we couldn't make it happen today, nothing was going to change next week. I then called care credit.

    I was approved for half of the amount I need. I cried, then pulled my self together and called my husband. While on the phone with him I was being called by a number I did not recognize. I didn't answer. I continued to talk to my husband and told myself that it just was not my time yet. I got off the phone with my husband and thought about stuffing my face with food to make me feel better but I stopped before ever taking a bite! I then went to my bedroom and had a real good cry. The kind I had been holding back all morning while on the phone.

   Then my phone rang. I was surprised to hear Lisa's voice. Lisa is the very nice woman who works at the hospital. She is the one who broke the bad news to me yesterday. I had already spoken to her this morning and told her I would call her when I was 100% sure what I was doing. I know they are chomping at the bit to fill my space at the hospital if I cancel.  I about started screaming! Lisa had called to say that the woman from BCBS had just called her since she could not reach me a few minutes ago. Apparently after speaking to me the BCBS woman started looking into my policy more. She had called to say that there was a chance that my surgery could be covered 100%!!!!! WHAT???? Apparently the wording in my policy was unclear and needed some investigating. HMMMM...okay, I will take it!

    One hour passes and BCBS calls me back and is still looking into the unclear wording of the policy.

 My phone rings again, an hour past the last phone call from BCBS.  The woman says, you got it! The surgery is covered 100%!!! I scream! I am in SHOCK! She says she will call the hospital and Dr's office and inform them.  I am still in shock! I don't know what happened and what changed and neither does anyone at the Dr's office. I am okay with that.  I will be having surgery in the morning, and BCBS is covering the surgery 100% and I pay nothing.

   The doctor's office said that they have everything documented and if there is a problem later on down the line after surgery they have their ducks in a row.  

  I am drained! I am so very happy right now! Thank you to everyone who prayed for me or sent kind words or advice. Thank you so very much! I am so lucky to have you all!

izzi

Thank you for your support. I will do exactly what you said to do! Maybe something will come of it!

Sorry to hear the troubles. I agree about the insurance commissioner. Also suggest filing an appeal with insurance, if you have enough co morbid issues.  If talking with the supervisor does not work, keep going up the chain. There may be folks higher up willing and able to do write offs or reductions. If Courtney gave you something in writing, that could be very helpful, as well. I wish you good fortune. 

I just finished reading your story and I am in tears!!  Congratulations!  So happy things worked out!

Oh no! I am stressing for you. I truly hope they get this figured out and that you can have your surgery as planned, keep us posted.

 Thanks, I am freaking out. I will keep you posted.

I am so sorry to hear the bad news! I really hope that it all gets worked out for you. I wish I could give you advice but I would definitely do what Kathy suggested. Just remember that everyone has a boss and you go as high up the chain as you need to. I will keep you in my thoughts.