They authorized back surgery but denied his $148,000 claim

Full story: Chicago Tribune

Michael Napientek of Clarendon Hills was in excruciating pain and needed back surgery.
Comments
1 - 20 of 622 Comments Last updated Jul 27, 2009
First Prev
of 32
Next Last

“http://tinyurl.c om/dgnlyl”

Since: May 08

Buffalo Grove, IL - HR-676!!!

#1 Jul 20, 2009
These f'n so-called "health-care" companies don't believe in health ... and they SURE don't believe in care.

Heartless f'n b a s t a r d s. I hope they all rot in he!!.
Dick Do Nothing Durbin

Chicago, IL

#2 Jul 20, 2009
Does not surprise me one bit that United Healthcare is involved in this. They usually pull the excuse that the provider filled out the forms incorrectly. Let's face it, socialized medicine is a scary proposition but at least it gives some leverage back to the employee. Now if we could only find the funds for Senator Roland's tombstone.
Hmm

Oak Park, IL

#3 Jul 20, 2009
Of course pre-authorization is only the first step in the authorization process. There are more steps, including authorization and post-authorization. During any of these steps of course the claim can be denied until there is triple dog dare you authorization.
Matt

Chicago, IL

#4 Jul 20, 2009
This is why we need national health care. I would rather wait a few months and pay $0, than get it right away and pay $148,000.

BTW, I am a contractor and work in Canada a lot. I have brought this up with people I work with many times and none of them have any horror stories about their health care. I, however, have many awful stories from family and friends here that can't afford to go to the doctor.
White Hot Spotlight

United States

#5 Jul 20, 2009
That is why the decision was reversed, the negative publicity. Shame on these people for giving a pre-authorization and then refusing payment. What a bunch of insurance company bean counting hacks.

I hope that this gentleman gets better and that his surgery was successful to alleviate his pain.

Alz

Since: Oct 08

Chicago

#6 Jul 20, 2009
Under Obamacare the pre-authorization could have been denied or delayed.

The rationing under Obama's plan isn't going to help, either.

People don't realize it (yet), but Obama's plan dumps us all (except the lawmakers themselves) into a big HMO - the government. That's right, the Federal Government will be the HMO.

Since private insurance will be non-existent or limited, we'll all be stuck.

So when problems happen, who are we going to complain to?

Alz

Since: Oct 08

Chicago

#7 Jul 20, 2009
Susan in Buffalo Grove wrote:
These f'n so-called "health-care" companies don't believe in health ... and they SURE don't believe in care.
Heartless f'n b a s t a r d s. I hope they all rot in he!!.
Read up on Canada or the UK. Their systems are a mess.

If you're sick enough to be admitted in a Canadian ER, the average wait is 23 hours.( http://tinyurl.com/pkr266 See page 9).

Whatever the problems with private insurance, from experience, we all should know that having the government make our health decisions is a huge mistake for each and every one of us.
Anon Y Mouse

Rolling Meadows, IL

#8 Jul 20, 2009
This isn't an issue of Health Care Reform, its the fact that its unfortunately business as usual in the Health Care industry.

The longer the company can delay the payment, the more money it makes.

With the State of Illinois regulators understaffed don't be surprised to hear more horror stories like this.

UHG should be fined for their actions, however even that is wishful thinking.

BTW, you want Healthcare reform, also have tort law reform too. Too many bogus malpractice cases settle because its cheaper than the consequences of a jury trial.
Ed McGuinness

Chicago, IL

#9 Jul 20, 2009
It's obvious that the turn about was due to the prospect of bad publicity. These insurance companies have a very long and deep record of controlling costs whenever and however. Its all about profit!

Health care reform NOW!
Kate

Burbank, CA

#10 Jul 20, 2009
If private health insurance are not able to compete with a government plan than they deserve to fail.

I hear a lot about the government is going to be between you and your doctor. Well right now the insurance company is between me and my doctor. I don't see the difference.

Bottom line health care in this country is broken. Health Care Professionals spend more time on paperwork than patients.

I don't know if the new health care plan proposed by the Obama Administration is a fix all but at least is a start. Doing nothing will just mean 75 million people will be without health care in 5 years vs. the 47 now.
Kris

United States

#11 Jul 20, 2009
And while this is a great example of what is flawed in our current system, under Obama's great healthcare plan, this poor guy would be on a waiting list for back surgery....unless of course any comorbidity such as hypertension or diabetes or obesity or smoking or just being "too old" precluded him from qualifying for surgery in the first place.
Right Wing Nut Case

Matteson, IL

#12 Jul 20, 2009
This is why although I pay lots for my health insurance, I'm afraid to use it. Out of the blue the insurance company can deny the claim for any or no reason and you won't know until it's too late. THIS IS BECAUSE HEALTH INSURANCE IS ABOUT MAKING MONEY FOR THE INSURFANCE COMPANIES, NOT ABOUT INSURING ANYBODY'S HEALTH!!!

Mark Kirk can blow all the hot air out his a** he wants to but if people like him get elected to the senate, we can all go die in the street for all he cares. If I'm down on Obama it's for his tendency to cave in to the greedy repugs for no reason. THIS TIME WE ALL NEED TO STAY STRONG JUST TO SAVE OUR OWN LIVES FROM THE LOUSY TRASH-TALKING GREED HEADS.

It's becoming un-American to do the right thing but this time, for heaven's sake, let's get this done, now.
CUU

Danville, IL

#13 Jul 20, 2009
Alz wrote:
<quoted text>
Read up on Canada or the UK. Their systems are a mess.
If you're sick enough to be admitted in a Canadian ER, the average wait is 23 hours.( http://tinyurl.com/pkr266 See page 9).
Not what it says at all. Average wait to discharge is about what it is in the US. The part of the chart you are reading is average time from presentation in the ER to getting into an inpatient bed in the hospital, for people needing to stay in the hospital after their ER care is over...

“Waiting for something good!”

Since: Apr 08

Location hidden

#14 Jul 20, 2009
This is (or was) a common scam with the less scrupulous healthcare providers; approve the treatment, then months later, deny it retroactively.

I've been caught by this myself. These companies rely on the consumer being too laid up or too disheartened to fight them for the right of coverage.

There are LAWS NOW in the process that will force these lugubrious insurers to toe their own rules, instead of changing them to fit past cases.
Lou

Elk Grove Village, IL

#15 Jul 20, 2009
Alz wrote:
Under Obamacare the pre-authorization could have been denied or delayed.
The rationing under Obama's plan isn't going to help, either.
People don't realize it (yet), but Obama's plan dumps us all (except the lawmakers themselves) into a big HMO - the government. That's right, the Federal Government will be the HMO.
Since private insurance will be non-existent or limited, we'll all be stuck.
So when problems happen, who are we going to complain to?
Yet another stupid post from Moron #1, Alz. OK, Alz, let's just keep it the way it is - only 47 million uninsured and growing every year.

Under the Obama plan, you have a choice, you dense-headed imbecile. You can choose. If the government plan is inept, then the health care providers have nothing to worry about, do they? What, are they scared? If they're so great, everyone will stick with them, and their CEO's can still rake in their $20 million salary and $50 million bonuses every year.
Lou

Elk Grove Village, IL

#16 Jul 20, 2009
CUU wrote:
<quoted text>
Not what it says at all. Average wait to discharge is about what it is in the US. The part of the chart you are reading is average time from presentation in the ER to getting into an inpatient bed in the hospital, for people needing to stay in the hospital after their ER care is over...
Don't confuse this guy with facts - he hates it when people do that.
chigirl

Carol Stream, IL

#17 Jul 20, 2009
Just another reason for reform. Insurance companies do this all the time. There is no rhyme nor reason for many of their decisions. Why Congress insists on including these bloodsucking companies as part of reform is beyond me. The fact that insurance companies are spending millions to eliminate a government option just proves that they want no competition for the 50 million unisured that will be forced to pay huge amounts of money for coverage. I truly wish that a single-payer option was the only option but that will probably not happen. It should at least be an option and a big part of reform.

Oversight of insurance companies also needs to be included to make sure their bag of dirty tricks is at least made less effective. Charging a family of three over $1200/month for limited coverage while Congress gets a cadillac policy that costs almost nothing needs to be stopped. Getting preapproval like this family did, only to have it initially rejected until the press got involved, needs to be stopped. Having a fully insured (by Humana) woman pay over $1000 per month for chemo because these drugs aren't covered needs to be stopped. The list goes on and on.

I would also like to see a list of every member of Congress and the amount of contributions each has received from the health care giants. CEO salaries and bonuses should also be made very public, listed in every newspaper every day until reform is passed by a reluctant Congress.

Let's really be transparent. Tell the citizens about the great health care that a member of Congress receives for his/her entire life at the lowest rate around while the rest of us are waiting for them to decide on our health care plans. I'm sure many would be surprised.
chigirl

Carol Stream, IL

#18 Jul 20, 2009
Right Wing Nut Case wrote:
This is why although I pay lots for my health insurance, I'm afraid to use it. Out of the blue the insurance company can deny the claim for any or no reason and you won't know until it's too late. THIS IS BECAUSE HEALTH INSURANCE IS ABOUT MAKING MONEY FOR THE INSURFANCE COMPANIES, NOT ABOUT INSURING ANYBODY'S HEALTH!!!
Mark Kirk can blow all the hot air out his **** he wants to but if people like him get elected to the senate, we can all go die in the street for all he cares. If I'm down on Obama it's for his tendency to cave in to the greedy repugs for no reason. THIS TIME WE ALL NEED TO STAY STRONG JUST TO SAVE OUR OWN LIVES FROM THE LOUSY TRASH-TALKING GREED HEADS.
It's becoming un-American to do the right thing but this time, for heaven's sake, let's get this done, now.
Perfect!! I totally agree. We all need to write to every member of Congress and let them know what is expected by working people. I truly hope there is a sane opponent to Kirk. He does not deserve to be in Congress in any capacity.
chigirl

Carol Stream, IL

#19 Jul 20, 2009
Alz wrote:
Under Obamacare the pre-authorization could have been denied or delayed.
The rationing under Obama's plan isn't going to help, either.
People don't realize it (yet), but Obama's plan dumps us all (except the lawmakers themselves) into a big HMO - the government. That's right, the Federal Government will be the HMO.
Since private insurance will be non-existent or limited, we'll all be stuck.
So when problems happen, who are we going to complain to?
Why is this poor soul allowed to comment on anything? Can't the Tribune do more to vet out the ignorant?
Jean

Addison, IL

#20 Jul 20, 2009
That insurance guy was lying through his teeth. What a scumbag company.

Tell me when this thread is updated: (Registration is not required)

Add to my Tracker Send me an email

First Prev
of 32
Next Last

Add your comments below

Characters left: 4000

Please note by submitting this form you acknowledge that you have read the Terms of Service and the comment you are posting is in compliance with such terms. Be polite. Inappropriate posts may be removed by the moderator. Send us your feedback.

Clarendon Hills Discussions

Title Updated Last By Comments
IL Ill. House Approves Legalizing Same-Sex Civil U... (Dec '10) 21 min Death Angel 49,473
Emmanuel Dominguez missing?! (Nov '13) 2 hr Comical Stupidity 1,193
What happened to the Hillside Shopping Center? (Mar '08) 7 hr Bill 514
IL Illinois Governor Recall Amendment (Oct '10) Sun Corrupt Democrats 1,908
Bensenville police chase ends in Itasca (Oct '13) Sat Judge Judy 2
Watch out for this sex offender Sat nt yippie 2
Ugliest Mel Pk Cop Contest (Feb '14) Aug 30 WWMichaelCastellanDo 17
•••
•••
Clarendon Hills Dating

more search filters

less search filters

•••

Clarendon Hills Jobs

•••
Enter and win $5000
•••
•••

Clarendon Hills People Search

Addresses and phone numbers for FREE

•••

Clarendon Hills News, Events & Info

Click for news, events and info in Clarendon Hills
•••

Personal Finance

Mortgages [ See current mortgage rates ]
•••