Quote:
Originally Posted by Shawnee123
I say the system is set up for otherwise intelligent people to make mistakes.
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You are correct.
Several years ago, I had some elective surgery done. I was concerned about the cost, so I read up about the coverage. Found a doctor in the network. Called the insurance company beforehand and explained what I was getting done. Read the insurance book. I was assured by everyone that it was going to be 100% covered, minus a $20 co-pay. I could hardly believe it was true, but when the rep at the insurance company told me it was true. I believed it.
Later, they refused to pay like $600 of the costs. It turns out that because the doctor did the procedure in a surgery center instead of in his own office, they wouldn't cover it the same way. I assumed that "in-office" procedures meant that it wasn't done in a hospital. What it really means is that the office it's done in is the same office that the doctor has his main practice. The office location where he does his surgery doesn't count as "in-office" because other doctors use it too.
I'm a fairly intelligent person. I read the damn book. I talked to people. And still, they got me. I made a mistake and paid for it.