The Cellar - View Single Post

vsp · 01-09-2003, 05:26 PM

In early November, I came down with a nasty bout of bronchitis. It never turned into pneumonia, thankfully, but I'm still coping with some of the aftereffects. It led to one 5 AM emergency room visit (when an asthma-like attack brought on by coughing left me unable to breathe for a few seconds), a handful of doctor visits, two trips to an ear-nose-throat specialist, a Thanksgiving Day trip to the hospital to drop off a specimen, and a number of prescriptions.

I was afraid that the emergency room visit would end up costing me a fortune, but when the bill came, insurance covered all but about $20. Likewise for the remainder of my visits -- except one.

The first time I went to the ENT specialist, he put a tube into my nose to see what he could see in my sinuses and throat. Once he got it into position, he looked around for about five seconds, removed it, said "I can't see anything physically wrong" and sent me on my way.

Apparently, according to CIGNA, that tube-in-the-nose qualifies as "Surgery - Outpatient" and is subject to a deductable, and thus I found a bill for around $150 in my mailbox this evening. The HELL?

At no time did the doctor tell me before putting the tube in that this was a "surgical" procedure, or that it wasn't just a routine part of a visit to his office. (I'd had it done once before, long ago in the only other time I visited a (different) ENT's office, and don't remember having to pay anything but my usual copay.) I certainly had no idea that the "I don't see anything" five-second tube would cost more than three visits to my regular physician, two months of prescriptions and an emergency room trip COMBINED.

Objects aren't flying around the room... yet. I am trying to decide how best to contest this -- whether to bend the ears of CIGNA's phone drones, the ENT's office, or both. Any suggestions as to how to proceed?

01-09-2003, 05:26 PM	#1
vsp Syndrome of a Down Join Date: Jun 2001 Location: West Chester Posts: 1,367	the joys of raw, blinding anger In early November, I came down with a nasty bout of bronchitis. It never turned into pneumonia, thankfully, but I'm still coping with some of the aftereffects. It led to one 5 AM emergency room visit (when an asthma-like attack brought on by coughing left me unable to breathe for a few seconds), a handful of doctor visits, two trips to an ear-nose-throat specialist, a Thanksgiving Day trip to the hospital to drop off a specimen, and a number of prescriptions. I was afraid that the emergency room visit would end up costing me a fortune, but when the bill came, insurance covered all but about $20. Likewise for the remainder of my visits -- except one. The first time I went to the ENT specialist, he put a tube into my nose to see what he could see in my sinuses and throat. Once he got it into position, he looked around for about five seconds, removed it, said "I can't see anything physically wrong" and sent me on my way. Apparently, according to CIGNA, that tube-in-the-nose qualifies as "Surgery - Outpatient" and is subject to a deductable, and thus I found a bill for around $150 in my mailbox this evening. The HELL? At no time did the doctor tell me before putting the tube in that this was a "surgical" procedure, or that it wasn't just a routine part of a visit to his office. (I'd had it done once before, long ago in the only other time I visited a (different) ENT's office, and don't remember having to pay anything but my usual copay.) I certainly had no idea that the "I don't see anything" five-second tube would cost more than three visits to my regular physician, two months of prescriptions and an emergency room trip COMBINED. Objects aren't flying around the room... yet. I am trying to decide how best to contest this -- whether to bend the ears of CIGNA's phone drones, the ENT's office, or both. Any suggestions as to how to proceed?