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?

UPDATED: May 22, 2012

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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


FreeAdvice Contributing Attorney / FreeAdvice Contributing Attorney

Answered 10 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.

IMPORTANT NOTICE: The Answer(s) provided above are for general information only. The attorney providing the answer was not serving as the attorney for the person submitting the question or in any attorney-client relationship with such person. Laws may vary from state to state, and sometimes change. Tiny variations in the facts, or a fact not set forth in a question, often can change a legal outcome or an attorney's conclusion. Although AttorneyPages.com has verified the attorney was admitted to practice law in at least one jurisdiction, he or she may not be authorized to practice law in the jurisdiction referred to in the question, nor is he or she necessarily experienced in the area of the law involved. Unlike the information in the Answer(s) above, upon which you should NOT rely, for personal advice you can rely upon we suggest you retain an attorney to represent you.

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