Forum Discussion
darsben
Apr 26, 2015Explorer II
Most policies of the type require hospitalization some are worse than GS.
You mention the brochure but not the POLICY surely you were given one but never read it. I am not blaming you because I never read them either until I got burned once.
If you would have come here first and asked someone may have helped you avoid the GOTCHA. Instead you chose to join to complain because they followed the terms of the policy and you are upset. Surely as a physician your practice went round and round with insurance companies denying coverage because of the stipulations in the contract.
As a further gotcha some policies will only evacuate a person only if the hospital they are in is unable to treat the case and then the evacuation is only to the nearest hospital capable of treating the condition; but only after consulting with the medical director of the insurance company. If procedure not followed claim will be denied even if later the insurance company agrees. So the Burn victim is screwed as is the stroke patient and the heart attack patient if at a small rural hospital
You mention the brochure but not the POLICY surely you were given one but never read it. I am not blaming you because I never read them either until I got burned once.
If you would have come here first and asked someone may have helped you avoid the GOTCHA. Instead you chose to join to complain because they followed the terms of the policy and you are upset. Surely as a physician your practice went round and round with insurance companies denying coverage because of the stipulations in the contract.
As a further gotcha some policies will only evacuate a person only if the hospital they are in is unable to treat the case and then the evacuation is only to the nearest hospital capable of treating the condition; but only after consulting with the medical director of the insurance company. If procedure not followed claim will be denied even if later the insurance company agrees. So the Burn victim is screwed as is the stroke patient and the heart attack patient if at a small rural hospital
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