C
ceecat
Guest
What is the name of your state? CA
I have had kidney stones (4) for about 3 years. I was with Kaiser but due to a move, the nearest hospital was an hour away and we could never get appointments with the doctors here. So, at the beginning of this year, we switched to Blue Shield.
In October/November of last year, we discovered (through Kaiser) that I have 2 kidney stones. I was advised by the Urologist at the time that I didn't necessarily need to have surgery and advised that the worst that could happen is I could develop an infection or blockage. I didn't schedule surgery as a result (but even if I had, it would have most likely been a 3-4 month wait!)
We switched to Blue Shield at the beginning of the year so that we could get access to doctors in this area.
On May 9, I had a kidney stone attack of huge proportions and had to go to the emergency room. Got some Demoral, an MRI and 2 x-rays. Kidney stones are still there.
Now, Blue Shield has sent me a notice saying the billing amount is approx $7,000. and they are inquiring about my prior insurance i.e. Name, policy number, etc.
What am I required to give them as far as information? I gather this would be a pre-existing condition - who will be responsible for payment? Will Blue Shield deny the claim and try to make Kaiser pay for it, or am I going to be refinancing my house to pay for it? I have no idea how to approach this. I've been on medications for the stones, but developed these last two WHILE on medication, so it's a condition that will be ongoing... I can perhaps switch back to Kaiser in October (open enrollment) but would rather not. I have been advised that I should now seek surgery to pulverize the stones, but now will that be covered?? Am I just out of luck as far as Blue Shield paying for this?
Sorry so lengthy - I have no clue what my next steps should be! Thanks for any advice!
I have had kidney stones (4) for about 3 years. I was with Kaiser but due to a move, the nearest hospital was an hour away and we could never get appointments with the doctors here. So, at the beginning of this year, we switched to Blue Shield.
In October/November of last year, we discovered (through Kaiser) that I have 2 kidney stones. I was advised by the Urologist at the time that I didn't necessarily need to have surgery and advised that the worst that could happen is I could develop an infection or blockage. I didn't schedule surgery as a result (but even if I had, it would have most likely been a 3-4 month wait!)
We switched to Blue Shield at the beginning of the year so that we could get access to doctors in this area.
On May 9, I had a kidney stone attack of huge proportions and had to go to the emergency room. Got some Demoral, an MRI and 2 x-rays. Kidney stones are still there.
Now, Blue Shield has sent me a notice saying the billing amount is approx $7,000. and they are inquiring about my prior insurance i.e. Name, policy number, etc.
What am I required to give them as far as information? I gather this would be a pre-existing condition - who will be responsible for payment? Will Blue Shield deny the claim and try to make Kaiser pay for it, or am I going to be refinancing my house to pay for it? I have no idea how to approach this. I've been on medications for the stones, but developed these last two WHILE on medication, so it's a condition that will be ongoing... I can perhaps switch back to Kaiser in October (open enrollment) but would rather not. I have been advised that I should now seek surgery to pulverize the stones, but now will that be covered?? Am I just out of luck as far as Blue Shield paying for this?
Sorry so lengthy - I have no clue what my next steps should be! Thanks for any advice!