question about excellus bcbs

question about excellus bcbs

Posted in the Utica Forum

worried

Camillus, NY

#1 Dec 18, 2011
I was recently brought to the ER, admitted, and operated on the next day. Neither the hospital or my surgeon sought prior authorization for the admittance or the surgery, and I didn't really know what was going on at the time and didn't call my self and ask.
I checked online and saw the bcbs denied my claim because there was no prior authorization. How much of a headache am I in for when I call them tomorrow?
If any excellus service reps read this I would really appreciate your help!
19703ced

Fort Atkinson, WI

#2 Dec 21, 2011
you will end up having to file a grievance a lengthy process 3 months easy
New Yorker

Utica, NY

#3 Dec 21, 2011
worried wrote:
I was recently brought to the ER, admitted, and operated on the next day. Neither the hospital or my surgeon sought prior authorization for the admittance or the surgery, and I didn't really know what was going on at the time and didn't call my self and ask.
I checked online and saw the bcbs denied my claim because there was no prior authorization.
I feel bad for you and hope this gets resolved in your favor. I think it's rotten that insurance companies can get away with this! Common sense: if you have been brought to the emergency room and admitted, most likely you aren't in a position to advocate for yourself as you are most likely very sick, in pain, incoherant.. As you have said you didn;t know what was going on and didn't call them yourself..but you should not be in the position of having to do that, while you are being treated and prepped for surgery. It's the job of hospital clerical people to do all of this insurance authorization, paperwork, etc. You as the patient should be left alone to recover in peace and not have to worry that one trip to the emergency room that resulted in surgery has the potential bankrupt you if BCBS weasles out of paying based on the "failure of the hospital and the surgeon to obtain prior authorization." Good luck and hope you are feeling better.
Trish

Syracuse, NY

#4 Dec 22, 2011
New Yorker wrote:
<quoted text>I feel bad for you and hope this gets resolved in your favor. I think it's rotten that insurance companies can get away with this! Common sense: if you have been brought to the emergency room and admitted, most likely you aren't in a position to advocate for yourself as you are most likely very sick, in pain, incoherant.. As you have said you didn;t know what was going on and didn't call them yourself..but you should not be in the position of having to do that, while you are being treated and prepped for surgery. It's the job of hospital clerical people to do all of this insurance authorization, paperwork, etc. You as the patient should be left alone to recover in peace and not have to worry that one trip to the emergency room that resulted in surgery has the potential bankrupt you if BCBS weasles out of paying based on the "failure of the hospital and the surgeon to obtain prior authorization." Good luck and hope you are feeling better.
Bcbs is the worst insurance ever!

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