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  1. #1

    Default It took 19 months....

    After 16 months of battling with BCBS about the air ambulance bill from November 2016 I sent the bill for $60,000.00 to DAN. It took a few months of going through the proper channels that DAN required and I was informed yesterday that they paid my air ambulance claim. I figured DAN could negotiate a decent discount however they only received a $1200 discount therefore they cut a check for $58,800.00. My $125 Guardian plan saved me $58,800.00 not to mention the other tens of thousands of $$ in medical bills. BCBS denied multiple appeals by myself, the air ambulance company and DAN tried to work with them as well. BCBS denied it every time saying the flight was not medically necessary even with the drafted letter signed by the BSN and hyperbaric physician stating otherwise. If you dont have DAN or some type of divers insurance, IMO you should look into it. Its loomed over my head for 19 months worrying that I would have a lot of dive gear for sale if I had to end of paying it. If it happens a 3rd time I will have a lot for sale... that or Ill be divorced.
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    Derek

  2. #2

    Default

    I just renewed my DAN membership... after last weekend I was really watching the saturation bar on my dive computer and thinking...... gee... what if.... Nice to hear something positive about DAN lately...

    Why yes that was me in shorts and a t-shirt @ the 700' marker

  3. #3
    Member
    Join Date
    Jun 2011
    Location
    St Petersburg, FL
    Posts
    2,883

    Default

    Did bcbs try to deny any other part of your care since it was due to diving. I always wondered how much was covered by primary insurers in these cases.


  4. #4
    Member
    Join Date
    Aug 2013
    Location
    Roaming in Cave Country
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    Default

    good that u got all sorted out.

    I was luckier when i got flown from Lake City to west palm. MY primary insurer paid for everything and got a 30% across the board on all services rendered.

    Plane ride went from 65k to 55k


  5. #5

    Default

    They covered most of everything else besides the flight. There were some things they didn’t cover 100% but DAN picked up the remainder of those as well. I think between the 2 DCS occurrences BCBS and DAN paid out around $150k. I haven’t had a dime out of pocket. BCBS even covered my PFO surgery. The hospital bill for the surgery was over $102,000.00. No clue why it was that much and no clue how much BCBS had to pay out. I had $438 out of pocket on the surgery. The Doctor fee was a small fraction of that and completely separate. His fee was extremely reasonable. I dont know what all the hospital charges were for. $102k seemed outrageous. The doctor can possibly elaborate on the hospital fees.

    Derek

  6. #6

    Default

    I am currently fighting with Aetna and appealing my claims for hyperbaric treatment in St. Croix. At first they denied due to being out-of-network even though I am covered for emergencies if out-of-network. Now they are denying due to not being prequalified for the treatments. How in the heck do you prequalify for an unplanned emergency?

    DAN has been nothing short of awesome during this entire ordeal.

    No naked pictures, just dive stuff. Click Here

  7. #7
    Member
    Join Date
    Aug 2013
    Location
    Roaming in Cave Country
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    Default

    Quote Originally Posted by Pullnglide View Post
    They covered most of everything else besides the flight. There were some things they didn’t cover 100% but DAN picked up the remainder of those as well. I think between the 2 DCS occurrences BCBS and DAN paid out around $150k. I haven’t had a dime out of pocket. BCBS even covered my PFO surgery. The hospital bill for the surgery was over $102,000.00. No clue why it was that much and no clue how much BCBS had to pay out. I had $438 out of pocket on the surgery. The Doctor fee was a small fraction of that and completely separate. His fee was extremely reasonable. I dont know what all the hospital charges were for. $102k seemed outrageous. The doctor can possibly elaborate on the hospital fees.
    US bills are typically detailed so you can see a lot of nitty gritty. Thats how i found out that an IV bag is $175 (insane)

    Provider Costs
    Lake City Medical Center $4,895.00
    Lake City Medical Center - Dr Torres $1,358.00
    Century Ambulance $859.02
    Air Methods $64,999.00
    Tenet Florida Physician Services $481.00
    Tenet Florida Physician Services $254.00
    St. Mary's Hospital $27,717.00
    St. Mary's - Dr Guirguis $264.00
    Sheridan Radiology $296.00
    Sheridan Radiology $66.00
    Palm Beach Pathology $155.00
    Enterprise Rent-a-Car $91.06
    Tolls $16.81
    Gas $22.00
    Uber $28.80
    $101,502.69

    That was my breakdow pre-insurance discounting which totaled $70,839.50


  8. #8
    Member
    Join Date
    Jun 2011
    Location
    St Petersburg, FL
    Posts
    2,883

    Default

    Quote Originally Posted by Pullnglide View Post
    They covered most of everything else besides the flight. There were some things they didn?t cover 100% but DAN picked up the remainder of those as well. I think between the 2 DCS occurrences BCBS and DAN paid out around $150k. I haven?t had a dime out of pocket. BCBS even covered my PFO surgery. The hospital bill for the surgery was over $102,000.00. No clue why it was that much and no clue how much BCBS had to pay out. I had $438 out of pocket on the surgery. The Doctor fee was a small fraction of that and completely separate. His fee was extremely reasonable. I dont know what all the hospital charges were for. $102k seemed outrageous. The doctor can possibly elaborate on the hospital fees.
    This is your second hit? Was this one before or after pfo closure?

    Hospital fees are nuts.


    Sent from my iPhone using Tapatalk


  9. #9

    Default

    It was before. The closure was done 45 days after the 2nd time.

    Derek

  10. #10

    Default

    Quote Originally Posted by patpicos View Post
    $101,502.69
    Almost $135k Canadian- wow!

    "Not all change is improvement...but all improvement is change" Donald Berwick


 

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