Insurance Denied Neurologist Recommended Procedure – Final Appeal Exhausted and Denied. What now?

I have Aetna Elect Choice Open Access and based in New Jersey.

As the title states, we recently went through the final appeal process (3rd review, I think?) for getting coverage for a 48-hour EEG monitoring procedure my wife's Neurologist had recommended we do. We learned an expensive lesson that we should get pre-approval of all procedures before we go through with them.

That said, what should be our next steps? We just got the bill with an itemized list of procedures we are being charged for to the tune of $2,500. I have access to Health Advocate through work, which will negotiate a reduction of the bill (of which Health Advocate will take a percentage of) — but it'd like to know my options before sticking with one. For example, would it be advisable to try to negotiate the bill down on our own?

Would it be out of the question to ask the Neurologist to delay the payments until next year until I can get my FSA re-charged for the year? At least if this is taken out of pre-tax dollars, it won't hurt as much.

I can't help but end this post with this: fuck shitty American healthcare. I'm already paying $21K out of pocket for just the insurance as it is. I'm probably closer to $24K with all co-pays and out of pocket expenses. This $2.5K bill is going to hurt.

submitted by /u/quokkabee
[comments]