Last year I had an emergency appendectomy. No warning, no time to plan, just an ambulance ride and surgery the same night. The procedure went well and I was home within three days, but the bills that came after scared me
The hospital bills started arriving about three weeks later. The total came out to just over $94,000. I had insurance, or so I thought.
Turns out my plan had a narrow network and the surgeon who operated on me was out of network, even though he was the on call doctor at an in network hospital.
I had no say in who cut me open that night. I was unconscious for part of it.
My insurer denied the surgeon’s portion entirely. That alone was $31,000.
A friend who works in healthcare told me to contact a claim lawyer. I reached out and they took my case for free, where I would only split a portion of the settlement.
The attorney filed a formal dispute under the No Surprises Act for the out of network surgeon charge. Because he was an on call provider at an in network facility during an emergency, the law was clearly on my side. The insurer reversed the denial within six weeks.
My final out of pocket came to nothing. Down from $94,000 which would have bankrupted me. As well as a 7k settlement for wrongdoing.
If something like this happens to you keep fighting and don’t let them win. The law is on your side. If you have any questions let me know.
Emergency to 94k in debt
byu/PurpleReflection001 inpersonalfinance
Posted by PurpleReflection001
9 Comments
mad respect for how you handled that, what a crazy situation. for anyone else reading this, definitely don’t hesitate to fight back against insurance – sounds like you came out way ahead after all that!
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Why does it have to be this complicated, why can’t healthcare costs be straightforward
Did you get compensated for your trouble. I mean you should get $5-10k or so for just going through all this.
In a similar case rn, where did you find your lawyer or whatever he’s called. Would help a lot thanks.
I don’t mean to sound weird, but you’re my hero. Seriously, the only way these guys back off is if you go right at them – and it takes guts to do it. Nice work!
Most States also have a State government office that handled things like this. Just FYI for everyone.
I just want to mention that my son had an emergency appendectomy in December. No ambulance ride, we drove him ourselves. I was expecting a huge bill but the full cost before insurance was less than 5k. That includes spending the night and leaving the next day. We paid his 1k deductible out of pocket. I thought we would get separate bills from maybe anesthesia or something buy we never did. It just boggles my mind how drastically different a bill can be depending on where you are in the US.
I’m so sorry you went through that and hope you are doing well.
Good on you. I was going to recommend the visible shame route contacting either NPR’s or other more local health care column that takes on issues like this… unnecessary in your case, thankfully. Glad to hear any success story, not to mention the successful surgery.