Emergency Room Charge Denied!

[Guest guest]

A few weeks ago I had severe pain in my midriff area, front and

back. I called my surgeon, but he was in surgery and couldn't get

back to me. I then called my PCP who told me to immediately get

to the emergency room of the hospital, because he was concerned

that I might be having a pulmonary embolism even though I was

several weeks out on my hernia repair/TT surgery. The emergency

room doctor found that I apparently had a strained or pulled

muscle. Since I haven't been exercising, I don't understand how it

happened. I just got notified that Blue Cross/Blue Shield is turning

down the emergency room charges because in their opinion I

should not have gone to the emergency room.

Obviously I will call on Monday and complain about the denial. GHI

which is my primary insurance has a " great " system. Anyone you

are permitted to speak with knows nothing and can make no

decisions. They enter the information in the computer and

someone else makes the decision and they never bother to inform

you of this!

Anyone ever have this type of problem? Any advice that you can

give me to help me deal with this idiocy?

Thanks

Sue

[Guest guest]

Just be persistent. You were directed there by a physician. It is easy

to make a call after the tests are done, but that does not help you if

you die from an undiagnosed pulmonary embolism. You are in the right.

Just keep at them.

Ray Hooks

For WLS nutrition info, visit

http://www.batiatricsupplementsystem.com

gemstein@... wrote:

>

> A few weeks ago I had severe pain in my midriff area, front and

> back. I called my surgeon, but he was in surgery and couldn't get

> back to me. I then called my PCP who told me to immediately get

> to the emergency room of the hospital, because he was concerned

> that I might be having a pulmonary embolism even though I was

> several weeks out on my hernia repair/TT surgery. The emergency

> room doctor found that I apparently had a strained or pulled

> muscle. Since I haven't been exercising, I don't understand how it

> happened. I just got notified that Blue Cross/Blue Shield is turning

> down the emergency room charges because in their opinion I

> should not have gone to the emergency room.

>

> Obviously I will call on Monday and complain about the denial. GHI

> which is my primary insurance has a " great " system. Anyone you

> are permitted to speak with knows nothing and can make no

> decisions. They enter the information in the computer and

> someone else makes the decision and they never bother to inform

> you of this!

>

> Anyone ever have this type of problem? Any advice that you can

> give me to help me deal with this idiocy?

>

> Thanks

>

> Sue

>

> Homepage: http://groups.yahoo.com/group/Graduate-OSSG

>

> Unsubscribe: mailto:Graduate-OSSG-unsubscribe

>

>

>

>

[Guest guest]

Just be persistent. You were directed there by a physician. It is easy

to make a call after the tests are done, but that does not help you if

you die from an undiagnosed pulmonary embolism. You are in the right.

Just keep at them.

Ray Hooks

For WLS nutrition info, visit

http://www.batiatricsupplementsystem.com

gemstein@... wrote:

>

> A few weeks ago I had severe pain in my midriff area, front and

> back. I called my surgeon, but he was in surgery and couldn't get

> back to me. I then called my PCP who told me to immediately get

> to the emergency room of the hospital, because he was concerned

> that I might be having a pulmonary embolism even though I was

> several weeks out on my hernia repair/TT surgery. The emergency

> room doctor found that I apparently had a strained or pulled

> muscle. Since I haven't been exercising, I don't understand how it

> happened. I just got notified that Blue Cross/Blue Shield is turning

> down the emergency room charges because in their opinion I

> should not have gone to the emergency room.

>

> Obviously I will call on Monday and complain about the denial. GHI

> which is my primary insurance has a " great " system. Anyone you

> are permitted to speak with knows nothing and can make no

> decisions. They enter the information in the computer and

> someone else makes the decision and they never bother to inform

> you of this!

>

> Anyone ever have this type of problem? Any advice that you can

> give me to help me deal with this idiocy?

>

> Thanks

>

> Sue

>

> Homepage: http://groups.yahoo.com/group/Graduate-OSSG

>

> Unsubscribe: mailto:Graduate-OSSG-unsubscribe

>

>

>

>

[Guest guest]

Just be persistent. You were directed there by a physician. It is easy

to make a call after the tests are done, but that does not help you if

you die from an undiagnosed pulmonary embolism. You are in the right.

Just keep at them.

Ray Hooks

For WLS nutrition info, visit

http://www.batiatricsupplementsystem.com

gemstein@... wrote:

>

> A few weeks ago I had severe pain in my midriff area, front and

> back. I called my surgeon, but he was in surgery and couldn't get

> back to me. I then called my PCP who told me to immediately get

> to the emergency room of the hospital, because he was concerned

> that I might be having a pulmonary embolism even though I was

> several weeks out on my hernia repair/TT surgery. The emergency

> room doctor found that I apparently had a strained or pulled

> muscle. Since I haven't been exercising, I don't understand how it

> happened. I just got notified that Blue Cross/Blue Shield is turning

> down the emergency room charges because in their opinion I

> should not have gone to the emergency room.

>

> Obviously I will call on Monday and complain about the denial. GHI

> which is my primary insurance has a " great " system. Anyone you

> are permitted to speak with knows nothing and can make no

> decisions. They enter the information in the computer and

> someone else makes the decision and they never bother to inform

> you of this!

>

> Anyone ever have this type of problem? Any advice that you can

> give me to help me deal with this idiocy?

>

> Thanks

>

> Sue

>

> Homepage: http://groups.yahoo.com/group/Graduate-OSSG

>

> Unsubscribe: mailto:Graduate-OSSG-unsubscribe

>

>

>

>