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Doctors office/ medical insurance question

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Preguntas
it's pretty precious

Member since 1/07

3839 total posts

Name:
Lauren

Doctors office/ medical insurance question

Ugh. Does anyone know what I can do here-
my doctor prescribed a heart monitor, which was mailed to me. I used it, the end.
My provider is saying that the brand of monitor is out of network, and thusly, I am responsible for the $450 bill I received! CRAZY!
They say I am responsible for knowing what brands of medical equipment are within my network! That's bananas, and regardless- this was just mailed to my door.
I tried searching on the provider's website, and there is NO WHERE to find that info.
Jerks.
Anyone know if the doctor's office should have researched this for me? I want to direct my fury appropriately.
Thank you. Chat Icon

Posted 8/25/11 4:21 PM
 
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Xelindrya
Mommy's little YouTube Star!

Member since 8/05

14470 total posts

Name:
Veronica

Re: Doctors office/ medical insurance question

I'd be upset at the doctors and myself.

Its the first question I ask.. "Is that covered by my insurance?" Anything and everything can be cleared with them first. If I get a 'sure it is' kinda answer, yeah I probably be mad at them for not checking. If I forgot to ask, I'd be mad at me.

But ultimately its the doctor who 'prescribed' the device. Just because he said 'use it' doesn't mean its covered by default. I had the same issue for my night guard (dental) and I'm having the issue now because I need a surgical extraction of a molar with a root canal and fractures. Its not 100% covered but I'm not going under the knife until EVERYONE agrees to each and every part of the procedure from the drugs, the surgery, the aftercare, the bone graft, everything.

Posted 8/25/11 4:29 PM
 

Preguntas
it's pretty precious

Member since 1/07

3839 total posts

Name:
Lauren

Re: Doctors office/ medical insurance question

But see having a heart monitor was covered. But the Brand name of the heart monitor is out of network. That's obscene.

Posted 8/25/11 5:46 PM
 

Xelindrya
Mommy's little YouTube Star!

Member since 8/05

14470 total posts

Name:
Veronica

Re: Doctors office/ medical insurance question

Posted by Preguntas

But see having a heart monitor was covered. But the Brand name of the heart monitor is out of network. That's obscene.



I don't disagree. I had to take home a 24 blood pressure monitor once. But still had to get it approved first. etc Chat Icon

Worst part about this is that is already done. Its not like you can say “Here take this back and give me the one that is covered” (or can you?) So what CAN you do? Call up the doc and say “You never said this wasn’t approved by my insurance?”

Annoying as it may be.. I always think of it this way… Thank god I didn’t desperately need it. Thankfully I got it when I did need it. Health is priceless.

Then again, that COULD explain why I’ve been making medical payments for procedures for the past 3yrs!!! I can never seem to afford any of my ‘care’.
Chat Icon

Posted 8/25/11 5:54 PM
 
 

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