Insurance company initially denies needed brain surgery saying surgeon is out-of-network



A Tennessee family said they were initially denied coverage for a surprise health emergency: A brain aneurysm. Anna Werner spoke to the family about the hurdles they faced to get the necessary brain surgery.

#news #healthcare #healthinsurance

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36 thoughts on “Insurance company initially denies needed brain surgery saying surgeon is out-of-network”

  1. Conservatives believe their boss SHOULD be making their health care decisions because they believe in a hierarchy and those above you make your decisions for you. That's how they think it's supposed to be.

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  2. This happened to me!!!! 3 days after giving birth to my baby I had post partum cardiomyopathy (basically heart failure due to pregnancy) I had a NDE and had to be resuscitated, well the wonderful ER doctor that SAVED MY LIFE was out of network and I got a bill for 9k…. I had to appeal their decision and write letters and do all this extra stuff to get them to pay.. they finally did but I had to work for it…..

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  3. Know what's amazing is the fact that when big national news companies like your self investigate crap like this and contact said insurance companies and demand answers then they cave otherwise they would have given the middle finger to these poor people and this kind of crap has to stop

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  4. Learn health literacy now and save lives later. Know your health insurance policy even if its from the same provider terms do change year to year. Know the law and know your rights. Please pay attention when you sign on the dotted line. It can be life changing. Also if you get a bill remember you can negotiate with hospitals, insurers, and other care providers. You will still have to pay but get a payment plan in place rather than it ruining your credit and jeopardizing other things you own. Also know you are not alone. I had classmates in undergrad who had medical debt, even professors. People of all ages go through these challenges.

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  5. I don’t understand why businesses don’t lobby for single payer. What a gigantic headache to choose and pay for and manage healthcare.

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  6. The US pays more than any other country in the world, yet ranks #30 in Healthcare. Children born with birth defects has quadrupled since 2000.
    Yet the Fortification Industry (the mandated 1998 synthetic petroleum based bioengineered chemical vitamins) that are added to milk and grain products will make over $80 Billion Dollars in 2023

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  7. Health insurance in America is a scam. I have UHC Medicare Advantage and they have denied numerous claims from doctors in their network. Ripping off senior citizens!!!

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  8. This is all too common. The bottom line is health insurance staff is making medical decisions to cut costs. They shouldn't even have a seat at the table when it comes to making medical decisions.

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  9. Nothing like tremendous stress from a health insurance company when you or a loved one could suffer or die from their greedy untrained decisions. Horrendously stupid.

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  10. I for sure thought that this was going to be UnitedHealthcare. They are notorious for pulling things like this. UnitedHealthcare recently sent me a list of in-network providers and THEN denied coverage when I chose one of them. They also denied to cover a wisdom tooth removal for one tooth, but paid for the second one. They are a horrible insurance company.

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  11. Another story a month or so ago covered one insurance company having a person denying thousands of claims an hour, or like 50,000 plus a day. Using AI – and just signing off hundreds in a batch. This is US healthcare. DENIED!

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  12. 3 weeks ago my doctor said I needed to switch my immunosuppressant since my Ankylosing Spondylitis wasn't improving. There's no cure for this disease but there are immunosuppressants to slow down the disease. My insurance has denied the prescription change. It's been a fight to get approval for the new immunosuppressant. I just want my disease to go into remission and I have no chance of that if insurance doesn't cover the immunosuppressant.

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  13. I’m a retired RN. This is horrible. If CBS hadn’t gotten involved I bet anything the Smiths would STILL have thousands & thousands of dollars owing…or they’d have a dead hubs & father. I’m so sorry. Another instance of *profits over people*…
    Disgusting

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  14. I was diagnosed with breast cancer and had tests 😢and one was 9,000ihad no way to pay for it they ran the tests without getting approval from my health insurance.

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  15. Yes my husband had a stroke and then blood clots he is 53 and the insurance would not pay for rehab the Doctors said he needed it but nope he had to come home and have home therapy 2 times a week for a hour ! This will do nothing for him now he wants to give up and die Thanks Aetna! Pay you every month and you don’t care!

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  16. No regulations, all profits… This is all health insurance companies are. They are completely happy to collect your monthly payment…but when it's time for them to do there part, they deny everything.

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  17. Too many times insurance companies deny coverage to save money, but it costs the insurance companies more in the long run because the medical care becomes more intensive. My cousin was denied medication for cystic fibrosis because he had lived beyond his life expectancy. The six-year fight to regain access to the medication caused so much damage to his lungs that he had to go through multiple hospitalizations. The medication was $6000 per year. The hospitalizations were thousands of times more than the medication cost. He died 5 days after his 31st birthday (his life expectancy was 13), and 3 days before a lung transplant match.

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  18. I don't know how much of this I believe. Bcbs is one the largest networks and converted health insurance providers in America. They are know for great coverage. EVERYBODY takes bcbs. And your telling me no neurosurgeon in their part of Chattanooga takes bcbs????? I find that hard to believe

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  19. Gayle is not Oprah. Go home! Go away!
    And FYI – she was not trying to find a random Doctor. She contacted the Payer & CHECK THEIR NETWORK. Of who he can see. Did u not pay attn? And what u had to say wasn’t even necessary.

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  20. This is a critical urgent care. An aneurysm can be sudden life or death.
    I thought hospitals had to treat critical needs.

    Hospitals may have charity funds.

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  21. I worked for a large insurance company during the ACA debate. Office next to the "death panel".

    Got a memo not to call it a death panel as that was being used as an argument against the ACA and that the public doesn't like the idea we have an entire dept of lawyers, doctors etc that works every day to find way to deny or limit care to terminal patients. Including children with cancer.

    It's not about healthcare, it's about what care they they can legally deny customers who paid a lot expecting healthcare.

    Reply

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