re: How many of you have truly been screwed over by an insurance company?

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$300 insurance thru work with BCBS, said the colonoscopy would be about $3k before the anesthetist fees. They couldn't even give me an estimate, said it'd be anywhere from $4k-6k. Went thru an "assist" program and got it done for $1700 out the door with all fees and any biopsy removal/assessment included.

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So, just for fun, and not being a “doctors aren’t the problem” guy (we are paid well. Less compared to our 80s/90s versions of ourselves), and there DOES need to be some payment for the staff involved and equipment used (I don’t rent it or pay them. The center/hospital provides them, and I have no real input as to what or who is available. I’m just the procedure monkey)



Here you’ll find the reimbursement for a colonoscopy (CPT 45378) to the physician is $200-350 roughly.

Medicare used a different code (G0121) but pays similarly.


I’ve got one payer who pays as little as around $120 for it. I do not actually know my max reimbursement or best payer (too many. Changes too much. I do them because there’s a need and I enjoy them far more than for the pay. I’d make a lot more if I stayed in my office and shipped all these out where they’d, in reality, just never get done). I think it’s closer to $400-450 though, but I could easily be wrong about that.

All those ‘Gordon’ billboards? Insurance companies could make them go away and still make money.

Hurricane f$&ked my roof. Leaks destroyed my brand new popcorn-free ceilings. Adjusters not only didn’t pay to replace the roof, but they wouldn’t even pay to fix the ceiling. 6 months after their recommended “repair”, my ceiling started leaking again. F$&k ‘em

Yes but don’t feel like airing my personal business here.

This does matter but not enough to go kill someone over.

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Insurer writes a letter stating test is approved, but no guarantee of payment. Of course, AFTER the test was performed and claim submitted Guess what? They denied the claim

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This gray area bull shite in all areas of life is what’s driving people crazy nowadays.

Had a tornado hit my commercial property during Ida. Caused about $2M in damages. Insurance company wanted to deny new roofs, failed exterior walls, and Sheetrock repairs because there may have been a leak there in the past, tried to get me to accept about $80k

Has to do the legal route and settle the claim through the umpire process. At the end of the day, they paid enough to cover a little more than all of my damages but I had to pay my attorney 25% of the award and an adjuster around $100k. In other words, because I had to get attorneys involved, I still had to come about $300k out of pocket.

I've always had TriCare or Federal Blue Cross, both pay very well.

Just had to pay $800 out of pocket to remove some moles that may have been cancerous. Baton Rouge clinic prices were above what insurance covered. It's not a denial, it just shows how shitty insurance is in this country.

Durable medical equipment is a really bad insurance provider scam area.
I have found that it is cheaper to pay whole sale cost out of my pocket, than it is to work through the Insurance co and its preferred supplier.
Preferred provider pedals retail pricing and copays. If you try to go out of network to a lower cost provider, the out of net work ins cover is minuscule . After okey coverage in late 1990's for mobility scooter[wife polio paralyzed] they went hard on the in net work requirement. On a phone call with ins company I described the lack of any in-net work suppliers nation wide.. Response was we do not have any. But if you submit a claim it will be out of network. the machines wear out at about 3 years, and I save about 800 dollars buying without the aid of my paid up insurance. Spinlife.com is my mobility equipment supplier.

CPAPs are another huge scam area by insurance company, both in the scandalous sleep study costing and rental of equipment. CPAP wholesalers can provide you with a new machine good for 4-5 years at the same cost of the in net work preferred provide for 10 months of rent.

The donut hole methodology of calculating your prescription balance is a scandal. You will never know what actual costs are but when calculating your cover, the insurance cover uses list prices that are almost never used because they are ten times market pricing. When I hit the donut hole it's time to go to Progresso Mexico for rational pricing.

You really have to be flexible in how to manage your doctors direction. I had both Knees replaced 4 years ago and the out of pocket cost was about 600 bucks each, great coverage. But I had to do the work as an out patient, less than 24 hours in facility. In patient cost to me would have been more 25000 each

Sometimes you just got to walk away. The federal government decision to disallow tramadol , an opioid to seniors pain management took the decision to use out of the authority of general practitioners. And set up a pain management scheme/clinic to cure patients of their pain. Wife and I at first meeting were told that his goal was to cure her polio effects through neurosurgeon referrals. We got up and walked out. There is no cure.

Gummy bears from the gas station work as well as tramadol and do not cause constipation