Billed 32k for a Surgery without knowing we would have to pay…
Hi Everyone,
I'm seeking advice regarding a challenging situation we're facing. Last month, my girlfriend broke her arm while snowboarding. At the time, she was working as a contractor through an agency called Actalent, which provided her with benefits. After consulting with her doctor, it was determined that she needed surgery to repair her arm. The doctor explained that without the surgery, the bone would likely slip out again due to her active lifestyle.
Before proceeding with the surgery on April 14th, the hospital obtained pre-approval from my girlfriend's insurance. We were initially informed that the pre-approval went smoothly. However, we recently received a bill of $32,000, as the insurance plan she had only covers appointments and non-emergency services. It appears there was a misunderstanding, as we were not aware that the surgery would not be covered despite receiving pre-approval. We do not have the means to pay the full amount, and the prospect of monthly payments of $200 for the next 24 years is just insane and depressing.
We have made several phone calls to both the insurance company and the hospital (Palo Alto Medical Foundation through Sutter Health). We are also in the process of applying for a charity grant that assists individuals with low income or those without insurance. Although my girlfriend's income qualifies for the grant, we were advised that it may only cover a portion of the $32,000.
We are feeling quite overwhelmed and uncertain about what to do next. While we are considering seeking legal representation to address this matter, it would involve additional costs. We believe that the hospital bears some responsibility for not informing us about the surgery not being covered despite receiving pre-approval. Any advice or suggestions would be greatly appreciated as we navigate this difficult situation.
Thank you for your help!
submitted by /u/Brotherton41
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