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lost all faith in the medical world

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  • lost all faith in the medical world

    lost all faith in the medical world... i am waiting for surgery but the hospital i'm supposed to have surgery at wont accept my insurance... same old same old MONEY before patients.. fed up with the political bullshit in the medical field...
    as i wait in pain watching my life go by... this was botched fusion i had when i broke my back and over time it fell apart

  • #2
    Sorry to hear that. Insurance plan years typically start on September 1 or January 1. With new plan years, changes in contracts between doctors, hospitals and the insurer can leave us having to find someone else in-network. Your surgeon may have privileges at more than on hospital in the area. Start by asking him or her. Otherwise go to the provider website and doing a search. It's frustrating to start over but hopefully you will find the help you need soon.

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    • #3
      i'm workers comp ...

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      • #4
        Do you have a worker's comp case manager?? If so, that person should be finding the hospital to have your surgery for you, and doing all that leg work (so to speak). I am assuming you did not take a lump sum settlement from WC and that they have the obligation to pay for your care like this.

        (KLD)
        The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

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        • #5
          let me thank you both for your thoughtful replies ..it's greatly appreciated..
          I would never settle out with my workers comp that would be foolish..
          I had a nursecase manager before , they were of limited help... when they say in the medical field to be your own advocate , I found out it's best I learn and be the best advocate i can be for myself to get thru this crazy system we call healthcare..
          Not that i don't want the help , because i do and did , just know the help your getting and who's paying for it..!!

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          • #6
            Still though, your surgeon and the hospital have to be assured payment by Worker's Comp and WC has to approve the procedure before a hospital will book the O.R.
            Call your surgeon tomorrow and ask if he/she has a nurse that liaisons with your state's Worker's Comp insurance. You shouldn't have to go through making arrangements by yourself.

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            • #7
              that was they other thing i have learned with having a spinal cord injury.. have to be careful where and who is providing you with healthcare..
              in they end it may not be the best outcome...

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              • #8
                surgery has been put on hold because hospital says they are waiting for approval frm WC..their is no pre approval for wc.. you get treatment and they bill and then it gets re priced under the workers compensation act..
                so as i am being told it's the hospital who haas cancelled my surgery and not WC..

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                • #9
                  I know in ny state for any kind of test or anything with WC involved you have to get pre-approval. This however should have started months ago when your surgery was planned.
                  T6 Incomplete due to a Spinal cord infarction July 2009

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                  • #10
                    no pre approval in the state of pa.. you go and get treatment and it gets re priced under the pa workers compensation act..

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                    • #11
                      as we speak i have and unstable fusion due to a botched fusion i had at the time of injury , and am hinged on the hardware , which is they only thing holding me up... when the hardware breaks it will be like getting injured all over again from the beginning..
                      lost faith in our healthcare

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                      • #12
                        I wasn't sure if I understood you correctly so I looked it up on the PA WC Website The hospital does not get pre-authorization from your WC insurer so it declines to allow the elective surgery because they don't know how much, or even if, they will get paid? As I said earlier, if your surgeon accepts WC patients without pre-authorization, he must have credentials to operate at hospitals that will do the same. Call tomorrow.
                        They also seem to anticipate the participation of Attorneys. Texas WC did away with this years ago but you might want to look into it if things don't work out.


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                        • #13
                          Thank you .. and Attorney will take 9 months to get a judgement on thru the court system..

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                          • #14
                            and the pin ponging continues between hospital and insurance company...

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