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Tue Feb 18, 2020, 04:19 PM

Patients Stuck With Bills After Insurers Don't Pay As Promised

By Lauren Weber
February 7, 2020


The more than $34,000 in medical bills that contributed to Darla and Andy Markley’s bankruptcy and loss of their home in Beloit, Wisconsin, grew out of what felt like a broken promise.

Darla Markley, 53, said her insurer had sent her a letter preapproving her to have a battery of tests at the Mayo Clinic in neighboring Minnesota after she came down with transverse myelitis, a rare, paralyzing illness that had kept her hospitalized for over a month. But after the tests found she also had beriberi, a vitamin deficiency, Anthem Blue Cross and Blue Shield judged that the tests weren’t needed after all and refused to pay — although Markley said she and Mayo had gotten approval.

While Darla learned to walk again, the Markleys tried to pay off the bills. Even after Mayo wrote off some of what they owed, her disability and Social Security checks barely covered her insurance premiums. By 2014, five years after her initial hospitalization, they had no choice but to declare bankruptcy.

Anthem Blue Cross and Blue Shield spokesperson Leslie Porras said company “records do not indicate that Ms. Markley had tests authorized that were later denied.”

https://khn.org/news/prior-authorization-revoked-patients-stuck-with-bills-after-insurers-dont-pay-as-promised/

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Response to BeckyDem (Original post)

Tue Feb 18, 2020, 04:30 PM

1. Typical for the American Criminal Enterprise Healthcare System.

The payers and the providers are a bunch of criminals.

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Response to democratisphere (Reply #1)

Tue Feb 18, 2020, 04:32 PM

2. Yep. These people had insurance. the thing that is suppose to protect you.

I post these stories often because it is as wrong as can be and we must confront the insurance industry.

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Response to BeckyDem (Reply #2)

Tue Feb 18, 2020, 04:35 PM

3. The entire American Healthcare System needs to dismantled

then reconstructed minus wall street.

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Response to democratisphere (Reply #3)

Tue Feb 18, 2020, 04:37 PM

4. +1

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Response to BeckyDem (Original post)

Tue Feb 18, 2020, 04:47 PM

5. Hmm, they tried for 5 years to pay those bills

Damn, weren't the hospitals and medical facilities willing to work with them? This is crazy. They were trying to pay.

Retrospective denial the new preexisting condition. Just another way for the average person to pay for a service they never get.

Just another capitalist scam to make the filthy rich even more rich.

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Response to Farmer-Rick (Reply #5)

Tue Feb 18, 2020, 05:05 PM

7. They are allowed to get away with it.

Some was discharged by Mayo but not nearly enough.

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Response to BeckyDem (Original post)

Tue Feb 18, 2020, 04:51 PM

6. Physicians who fail to diagnose properly and profit from testing are also a problem in this country.

Sounds to me that the Mayo clinic may have misdiagnosed an easily treated problem -- Beriberi -- while running around seeing how may tests they could rack up.

If so, Mayo and labs should have written off the tests as improper.

You want ACA, MFA, Public Option, etc., to fail, let physicians run any tests they want, especially when they profit off them.

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Response to BeckyDem (Original post)

Tue Feb 18, 2020, 10:24 PM

8. they behave as if the PATIENT should know what tests are needed

it is RIDICULOUS
it is a SCAM

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Response to Skittles (Reply #8)

Wed Feb 19, 2020, 08:40 AM

9. It is an orchestrated scam, no question about it.

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Response to BeckyDem (Original post)

Wed Feb 19, 2020, 12:06 PM

10. Here's another one: there's a law that says federal agencies are prohibited from ...

paying for treatment that another federal agency won't pay for full sum.

If Medicare pays 60% then VA cannot pay the rest. Who benefits from that? Secondary insurance schemes.

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Response to marble falls (Reply #10)

Wed Feb 19, 2020, 01:28 PM

11. I had never heard that one before, that is horrible.

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Response to BeckyDem (Reply #11)

Wed Feb 19, 2020, 01:31 PM

12. I found out the hard way, two weeks ago. There's some movement to fix it ...

but the insurance lobby isn't happy.

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Response to marble falls (Reply #12)

Wed Feb 19, 2020, 02:47 PM

13. Oh wow, I hope it can be fixed asap.

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