tag:blogger.com,1999:blog-401303964563152307.post2867857838900527817..comments2024-03-28T21:36:55.157-04:00Comments on Love That Max : How we won the $12,000 insurance lotteryEllen Seidmanhttp://www.blogger.com/profile/01433429847255621203noreply@blogger.comBlogger3125tag:blogger.com,1999:blog-401303964563152307.post-3766025268648662902017-08-24T10:04:37.159-04:002017-08-24T10:04:37.159-04:00Wow. I've never heard of a doctor requiring pa...Wow. I've never heard of a doctor requiring payment before surgery. One caution about insurance and out of network doctors. Years ago we used an out of network doctor for our son's scoliosis surgery. The doctor was willing to negotiate his fee, but we still did everything we could to get the insurance company to tell us what amount would be covered. In the end we paid nothing out of pocket. Then a year later, our insurance company said they processed the claim incorrectly and wanted us to pay them back $6,000....since it was an out of network doctor they hadn't paid him directly the first time...they paid us. The hospital filed an appeal for us and then the insurance company said, based on that information, they wanted $10,000 back. After my nervous breakdown, I appealed directly to my husband's union because they provide the insurance and have the last say. They sided with us....so we didn't have to pay...But it was very unsettling to learn an insurance company can change their decision after such a long period of time. So, as always in the world of special needs, get everything in writing so you can fight any unexpected future fight.Joanne De Simonehttps://special-educationmom.comnoreply@blogger.comtag:blogger.com,1999:blog-401303964563152307.post-32487443711385896482017-08-24T08:39:51.316-04:002017-08-24T08:39:51.316-04:00Insurance is the worst. We had to pay $1600/mo for...Insurance is the worst. We had to pay $1600/mo for PT for our daughter after insurance for our "in network" provider, when there is a closer option to our house that is much cheaper ($100/visit), but our insurance wouldn't cover it because the closer place was out of network and the other place was in netowrk and within 35 miles from our house (but still an hour drive in atlanta traffic) so frustrating! We now pay out of pocket for the $100/mo since it's obviously still the better deal. Paige Flammhttps://www.blogger.com/profile/12611640192527041942noreply@blogger.comtag:blogger.com,1999:blog-401303964563152307.post-76580715496474008642017-08-24T08:04:10.718-04:002017-08-24T08:04:10.718-04:00Oh insurance. I'm so glad they are covering it...Oh insurance. I'm so glad they are covering it although it is crazy that it took them to the week before surgery to do so. Kathrynnoreply@blogger.com