Had emergency surgery to remove my gallbladder. Anthem says that the procedure was not medically necessary and wont cover around $70,000. Should I do anything right now or wait until my EOB?

Age 29 Work provided Anthem EPO California

So just a preface, I'm a very anxious person so I need to know as much as I can before acting. This is all I can think about during the whole day while on medical leave. This is the first time in my life I have ever had to worry about an insurance denial.

I woke up in the middle of the night and I legitimately thought that I was dying, had to wait over 4 hours in excruciating pain throwing my guts up. When they got to me they sent me to surgery an hour and a half later.

The surgery only happened about 3 weeks ago. When checking the anthem website to see if I was gonna hit my out of pocket maximum, I see a denied claim of around $70000.The operating room and recovery room make up more than half the claim.

"*00866 Services determined not medically necessary – member responsibility."

Needless to say I freaked the fuck out. I was so confused because other charges from that hospital stay were being covered under that no surprises act.

I have not received a bill or a EOB yet and mychart says that I don't owe anything yet. Should I do ANYTHING right now or should I just wait until the EOB and the bill and then have all hands on deck?

submitted by /u/ImiQuestion
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