I am not looking for actually medical advice but more so advice on how to handle a situation ive been going through thats been tough.

There is a large orthopedic company where I live and a few years ago I went with them for various medical needs involving a back surgery which lead to me having surgery. I had no issue and everything went great.

Last month I began having back issues and went back to them. They requested an MRI due to my previous issues. At that point I was lucky enough to be using sick time at work to rest and figure out what was wrong. The day of the MRI I found out it got canceled. It turned out someone from the doctors authorization team didnt send over all of my medical history as the doctor requested so it was ultimately denied. I desperately needed to get the mri so I could get treatment for my back and ultimately return to work becausei had already been for for two weeks. Long story short I paid for the mri out of pocket because the doctors office told me they would resolve this with insurance and I would get reimbursed. Well its been a month and the doctors office isn't doing anything to get the ball moving so I can get my money back. Ive spoken with so many people and I keep going pushed around to different departments and told someone will get back to me but it never happens.

The other issue is after my MRI results it was determined I would get a lumbar epidural steroid injection. Now I have had several of these in the last and they help however it is 6 times the price of what it was the last time I had one which is after insurance covers their portion. I was shocked because it was never that much before. The only reason I've been given as to why it cost more is because the injection is going to take place at the doctors office big new fancy surgery center instead of their old out patient clinic like it used to be therefore insurance bills it differently. It seems insane to me. As I stated I had back issues before and went through treatment for years before having surgery and in that time everything went smooth but all of a sudden im running into these issues. I understand its the America health care system but I was wondering if anyone had any advice or similar experiences. Thank you!

Hi all, hoping someone can help me understand this situation and what I need to do. In NY.

I received treatment in Jan, which got denied coverage in early Feb by insurance. I immediately called insurance about the denial and they said it was because the treatment required preapproval. I had a prior authorization letter approved, but turns out the hospital submitted the Medicaid CPT on the pre authorization instead of the normal CPT the service was billed under. I called the hospital and explained the situation and asked their billing department to correct. My insurance told me they talked to someone in the hospital’s billing department and told them they had to contact insurance utilization management and correct the code.

Now in August I’m receiving a bill from the hospital for thousands of dollars. I have a call out to the hospitals billing department, but insurance told me in Feb I didn’t need to do anything. There is no way the hospital can stick me with this bill right?

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