What to do if I had a common surgery using newer technology but the doctor didn’t give me a choice andnow my insurer says it won’t pay it?

I had surgery. The doctor used a robot. He told me about using a robot but never gave me any other option for the procedure. The insurance company is now telling me they won’t cover it and the hospital is telling me I owe them $10K.

Asked on May 22, 2012 under Bankruptcy Law, Texas

Answers:

FreeAdvice Contributing Attorney / FreeAdvice Contributing Attorney

Answered 8 years ago | Contributor

If your treating physician did not provide you and your insurance carrier with a detailed explanantion in writing about the medical procedure that you would be undergoing for pre-approval purposes of the operation that you had and your insurance carrier because of the use of the "robot" for the operation refuses to pay for the operation, the issue is between your insurance carrier and your treating physician from what I see.

It does not seem fair to have you come out of pocket $10,000 for an operation that would have been covered by your health insurance policy just because your doctor used a "robot" for the procedure. I suggest that you, your doctor and a representative of your health insurance carrier have  a conference as to how the $10,000 bill is going to be resolved and paid.


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