This isn't the insurance industry's fault, and it wasn't a *huge* bill or anything, but: Last year, I had to spend a couple dozen hours over a few months trying to figure out why I got fully billed for a dermatology sample apparently being sent to a third-party diagnostics lab well outside my area of coverage. Turns out, the dermatologist had just failed to update her NPI from when she lived and practiced in a different state, so even though the sample almost definitely didn't leave the state, it got charged as being several states away. The dermatologist and her office staff were pretty awful about the whole thing; I had to casually remind them about their duty to update the NPI and the potential penalties for not doing so just to get them to send the bill back through
In the middle of post-graduate training, I was emergently hospitalized. My insurance refused to pay, citing a "pre-existing clause." This was after the ACA passed, so I thought such a denial would be illegal. Turns out a "pre-existing clause" refers to the possibility that, while uninsured (or maybe even just before starting their current insurance), a person developed a condition that predisposed them to whatever emergency the insurance company doesn't want to pay for.
My wife had to have ACL surgery a couple years ago. As part of post-op recovery, the surgeon prescribed a cooling unit and compression devices. Coverage for one of them (I don't remember which) was denied because it was "experimental therapy." My wife called the orthopedist who assured her that everything was routine post-op care. That's beside the fact that my wife was not asked if she wanted this alleged "experimental therapy" in the first place.
I work in a hospital. We routinely see patients who arrive with clots because they can't afford their anticoagulant. Or hyperglycemic crisis because they ran out of insulin. Or breakthrough seizures because insurance denied their prescription AED (like the one story above.)
This shit is common, and it's so fucking heartbreaking.
This isn't the insurance industry's fault, and it wasn't a *huge* bill or anything, but: Last year, I had to spend a couple dozen hours over a few months trying to figure out why I got fully billed for a dermatology sample apparently being sent to a third-party diagnostics lab well outside my area of coverage. Turns out, the dermatologist had just failed to update her NPI from when she lived and practiced in a different state, so even though the sample almost definitely didn't leave the state, it got charged as being several states away. The dermatologist and her office staff were pretty awful about the whole thing; I had to casually remind them about their duty to update the NPI and the potential penalties for not doing so just to get them to send the bill back through
In the middle of post-graduate training, I was emergently hospitalized. My insurance refused to pay, citing a "pre-existing clause." This was after the ACA passed, so I thought such a denial would be illegal. Turns out a "pre-existing clause" refers to the possibility that, while uninsured (or maybe even just before starting their current insurance), a person developed a condition that predisposed them to whatever emergency the insurance company doesn't want to pay for.
My wife had to have ACL surgery a couple years ago. As part of post-op recovery, the surgeon prescribed a cooling unit and compression devices. Coverage for one of them (I don't remember which) was denied because it was "experimental therapy." My wife called the orthopedist who assured her that everything was routine post-op care. That's beside the fact that my wife was not asked if she wanted this alleged "experimental therapy" in the first place.
I work in a hospital. We routinely see patients who arrive with clots because they can't afford their anticoagulant. Or hyperglycemic crisis because they ran out of insulin. Or breakthrough seizures because insurance denied their prescription AED (like the one story above.)
This shit is common, and it's so fucking heartbreaking.