Patients Stuck With Bills After Insurers Don't Pay As Promised
By Lauren Weber
February 7, 2020
The more than $34,000 in medical bills that contributed to Darla and Andy Markleys bankruptcy and loss of their home in Beloit, Wisconsin, grew out of what felt like a broken promise.
Darla Markley, 53, said her insurer had sent her a letter preapproving her to have a battery of tests at the Mayo Clinic in neighboring Minnesota after she came down with transverse myelitis, a rare, paralyzing illness that had kept her hospitalized for over a month. But after the tests found she also had beriberi, a vitamin deficiency, Anthem Blue Cross and Blue Shield judged that the tests werent needed after all and refused to pay although Markley said she and Mayo had gotten approval.
While Darla learned to walk again, the Markleys tried to pay off the bills. Even after Mayo wrote off some of what they owed, her disability and Social Security checks barely covered her insurance premiums. By 2014, five years after her initial hospitalization, they had no choice but to declare bankruptcy.
Anthem Blue Cross and Blue Shield spokesperson Leslie Porras said company records do not indicate that Ms. Markley had tests authorized that were later denied.
https://khn.org/news/prior-authorization-revoked-patients-stuck-with-bills-after-insurers-dont-pay-as-promised/
democratisphere
(17,235 posts)The payers and the providers are a bunch of criminals.
BeckyDem
(8,361 posts)I post these stories often because it is as wrong as can be and we must confront the insurance industry.
democratisphere
(17,235 posts)then reconstructed minus wall street.
BeckyDem
(8,361 posts)Farmer-Rick
(10,202 posts)Damn, weren't the hospitals and medical facilities willing to work with them? This is crazy. They were trying to pay.
Retrospective denial the new preexisting condition. Just another way for the average person to pay for a service they never get.
Just another capitalist scam to make the filthy rich even more rich.
BeckyDem
(8,361 posts)Some was discharged by Mayo but not nearly enough.
Hoyt
(54,770 posts)Sounds to me that the Mayo clinic may have misdiagnosed an easily treated problem -- Beriberi -- while running around seeing how may tests they could rack up.
If so, Mayo and labs should have written off the tests as improper.
You want ACA, MFA, Public Option, etc., to fail, let physicians run any tests they want, especially when they profit off them.
Skittles
(153,174 posts)it is RIDICULOUS
it is a SCAM
BeckyDem
(8,361 posts)marble falls
(57,157 posts)paying for treatment that another federal agency won't pay for full sum.
If Medicare pays 60% then VA cannot pay the rest. Who benefits from that? Secondary insurance schemes.
BeckyDem
(8,361 posts)marble falls
(57,157 posts)but the insurance lobby isn't happy.