United Healthcare Denying a Legit Claim

[Anonymous]

Anonymous wrote:OP here. Thanks to all for responses. A quick update: doctor's office advised us to call the lab and say we couldn't pay $2600, and they would cut it down to $200. That's what happened when we called. You figure it out. Another idiocy in our healthcare system. Lesson learned. Thanks again!

Glad you were able to negotiate it down. It's pretty common, though, for insurance plans to cover only some labs and not others. Just as you wouldn't go to a new doctor without confirming they took your insurance or schedule surgery at a hospital without making sure the hospital participates, you need to check labs too.

[Anonymous]

Glad things worked out for you, OP.

My ex just got hit with a big bill from his insurance company. He went to the ER for an emergency appendectomy after his appendix ruptured. They admitted him and booked him in for surgery. He finds out later that the anesthesiologist on staff at the time is "out of network" for him and now he is on the hook for the bill. He is pissed because what are you supposed to do, wait for the "in network" guy to come on staff and risk dying in the meantime?

Our health care system is screwed up.

[Anonymous]

I thought this was going to be a real complaint. For instance, I had a previous insurer (through my graduate school, so not chosen by me) who refused to cover an annual checkup. After arguing with them on an almost weekly basis for 8 months, they finally relented. They were absolutely in the wrong, and I still have no idea how they thought they would get away with that...except they probably get away with it all the time because no one else challenges them.

On the other hand, I now have the same insurer and doctor of which you complain and have never had an issue. I read through my coverage and understood that I had to use their chosen lab. Even if I hadn't, they make it pretty obvious by sending you that lab card. I made sure to tell my doctor (again, same practice) on the first visit, and they put a note in my file. I'm sorry to be snarky, but you simply have to read what they send.

But none of this means that I don't think our healthcare system is screwed up. I just play the hand I'm dealt.

[Anonymous]

god, the snark in the previous comment. I realize you "apologized" for it but wtf, hope your day has improved.

[Anonymous]

Anonymous wrote:On the other hand, I now have the same insurer and doctor of which you complain and have never had an issue. I read through my coverage and understood that I had to use their chosen lab. Even if I hadn't, they make it pretty obvious by sending you that lab card.

You're right, in America's health care system one should never assume anything. Common sense, the right thing, the wrong thing....it is all one joke of a system.

[Anonymous]

Anonymous wrote:Glad things worked out for you, OP.

My ex just got hit with a big bill from his insurance company. He went to the ER for an emergency appendectomy after his appendix ruptured. They admitted him and booked him in for surgery. He finds out later that the anesthesiologist on staff at the time is "out of network" for him and now he is on the hook for the bill. He is pissed because what are you supposed to do, wait for the "in network" guy to come on staff and risk dying in the meantime?

Our health care system is screwed up.

This happened to me too (also appendectomy), but we called them on just that issue and it ended up being covered under the emergency clause. If you don't have a choice, they do cover it.