Wtf? You should be able to appeal, but that's super messed up.

allbutspeechless: yep. I can appeal but it really is. Somehow me like. Needing morphine due to the pain I was in and my gallbladder being filled with stones and having walls like...half an inch thick means it wasn’t medically necessary

so many insurance companies just deny everything hoping you won't bother to appeal. its a racket.

SanuraSnowpaw: it’s ridiculous. I just do not have the energy to fight this but I have to.

it truly is.

SanuraSnowpaw: I really hate it. Like. I needed this. I went to the urgent care and they referred me to the er. Went to the er, they looked and took me straight to surgery. Like......CLEARLY not necessary. Obviously 🙄

it is bullshit.

SanuraSnowpaw: I just don’t get it.

Are you well now?

Tillie: sort of? I have a bag attached that my gallbladder is draining into...and I’ll still need surgery eventually....but I feel better now than I did.

Definitely call them back. There could be some kind of coding error going on from the hospital - it happens.

masharunya: I did today. They need more info I guess but dang - say that instead of DENIED haha.

Okay, GOOD that they're working to get more information! Hospital billing people should also be able to help? We have a financial counseling/assistance department at ours that helps sort out messes in addition to getting charitable coverage, but every hospital is different.

masharunya: yeah - I do have insurance and it should hopefully cover most/all of this. But oooooof. I hope I don’t have to fight with them come surgery 🙃

Depending on what's happening and on your insurance, the surgeon's office may have to get a pre-auth for it? When they start working on scheduling it with you, might want to inquire.

masharunya: I’ll deffo ask them that! Because I have zero clue at all and am flying blind with this.

Some surgeons/providers are consulting in a hospital system and aren't necessarily in network or are sort of this doctor version of a 'contractor'. NPR does this thing where they examine crazy bills and go over some of these pitfalls that can happen, especially in some hospital systems which I guess are notorious for inflating cost.

I hear you. For now, I hope you can just focus on getting better! ::hugs::

masharunya: it’s all so unknown to me. And scary. But I am trying to just get well so I can get this bum gallbladder out sooner rather than later.

Good!