Insurance Induced Aneurysm

You know those documents you get from your Insurance Company after you go to the Doctor, and (most of the time) before you get the bill from the Doctor?  Those documents that show you what the Doctor charged for the service, what the Insurance Company is contracted with the Doctor for said service and therefore are paying for that service, and finally what you owe the Doctor for the service?  Have you ever opened one of those and suddenly everything starts to go black and you can't breathe?

I had such a moment last night.  I will say that I love my Insurance Company.  I have never had an issue with them, and I feel for the premium my company pays and what I subsequently pay from my paycheck I have very good insurance.  Sure I have a deductible that must be met every year but who doesn't?  Overall I'm a healthy person.  I get colds and that's about it.  I don't get bronchitis, I've never had pneumonia, I don't have a long standing disease that requires multiple medicines or hospital stays or doctor visits...  And for that I'm very lucky and thankful.

This is what I opened last night:

That came out kind of small, but it says that the hospital charged my Insurance Company $5,924.25 for my outpatient surgery and my Insurance Company is paying a grand total of $0.00 for said charges.

What?!

My immediate reaction was to faint.  I know that there are several people who have had, and continue to have, Doctor bills that are much larger than this but I haven't.  Even with my two pregnancies my insurance at the time was FANTASTIC and I didn't pay a dime beyond my deductible. 

I wanted to cry, but I didn't.  Once I regained control of my body I said that there was no way I was paying nearly $6000 for a service authorized by my Doctor, who's in-network, performed by a doctor that was in-network and at a hospital that was in-network.

As it turns out, my Insurance Company agrees.  When I explained my concerns to the Representative she asked what the outpatient surgery was for.  Her exact response to me was "Oh, Honey.  No Way.  That service is SOOOO covered."  She went on to explain that the hospital coded the claim incorrectly and that she'll contact the hospital with a request to re-code and resubmit the claim along with my medical records to verify that the surgery wasn't an elective procedure.

Medical insurance is a fantastic concept, and I feel for anyone who cannot obtain it for whatever reason, but I guess this goes to show that you still have to be vigilant.