Wednesday, March 12, 2014

Surgery Postponed!

Today is my surgery day. As you are reading this you can correctly assume that I am not on the operating table. Yesterday morning Rachel calls and tells my mom that Cigna stood up two appointments with them for the peer to peer review. She claimed that they called and called and no one would talk to them. In my opinion, this should have been done weeks ago, not the 24 hours before surgery. There was an exchange of about 40 calls between me, my mom, Rachel, Cigna and Baylor Hospital with every roadblock you could imagine. In the end the result was that with or without Cigna's help I would still owe $19K and change on the day of surgery. This is because of TMJ fees being charged out of pocket. I paid for the TMJ surgery but there are separate fees the hospital gives you. This was never told to me. Rachel claims that she discussed it with me. She didn't. I think I would remember if she had said, "You will owe 19K on the day of surgery." In one of the conversations we had yesterday, she said "I'm confused because it's the same with all our patients that a down payment is due and I thought we discussed the 28K?" I said, "Yes, we discussed the $28K (which was wrong by the way) and you said I could work out a payment plan with them. 19K was never a number in the mix. A huge deposit was never discussed." I've never had surgery before and I relied a 100% on her to give me all the info that I need. After I learned that it was 19K down, I sent her an email and she acted shocked. She said that "She'd received my scary email." She acknowledged that the price wasn't right. She called Baylor after we talked and said they coded the surgery wrong. So...why is she mad that this was a surprise? She's acting like it was a surprise to her too? We need another week at least to borrow the money. I hung up with her and she called my mom. She told my mom, "This is kind of a big deal that you're canceling the day before." But there is nothing we can do. This deposit was sprung on us at the last minute and she didn't work out the peer to peer. We asked to reschedule and she said Dr. Franco doesn't have another opening until May. She said that she won't book another OR at Baylor until we pay everything up front. Too bad she wasn't that clear and forward a month ago! I called Cigna this morning at 6am and wanted to get my mom, dad and lawyers names on the approval list to talk to them and they said I had to fill out a form and send a fax that would take 3-4 weeks to process. There is no way to verify that they received the fax. So nothing is rescheduled, I didn't have the surgery, I lost 2 months of supplemental income for an ESL class I teach and I had to fire that girl that was covering me for the next month.

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