Despite pre-approval by insurance company, woman billed $3,100 by anesthesiologist
Dear Fixer: Last October, my wife had surgery at Palos Community Hospital. Prior to the surgery, I contacted my insurance company and received an authorization to proceed and was told that it was “in-network.”
Several weeks after the surgery, I received news that the anesthesia services were out-of-network. I contacted my insurance company, Great-West Healthcare, and was told they would put it under review.
My complaint is fairly simple. Both the hospital and insurer approved the surgery and told me it was in-network — then I learned, post-surgery, that statement was not true.
In an effort to play fair, I sent a check for $500 to the anesthesiologist.
Alan Howarth, Orland Park
Dear Alan: You’re a patient man. We’d probably want a whiff of nitrous oxide after receiving an unexpected bill of more than $3,100 for anesthesiology services we thought were covered. You told Team Fixer the anesthesiologist wanted you to pay $2,400 of it and have Great-West’s parent, CIGNA, pick up the balance.
You had already paid $900 out-of-pocket for the surgeon, hospital and other items.
Team Fixer asked CIGNA what they could do to help. CIGNA agreed that when they approved the procedure as in-network, the anesthesia services should have been included. They’ve agreed to pick up the balance of what the anesthesiologist claims he is owed.
Interestingly, you said CIGNA told you this is a common problem, but as long as you have an approval from an in-network doctor and hospital, the insurer should cover the whole thing as in-network — regardless of whether any out-of-network providers were involved.
Dear Fixer: I’m at my wits’ end. I own two apartment buildings on the South Side that I used to rent out. They have both been vacant for some time. One of the buildings had a fire on Aug. 6, 2009.
I had already been considering not renting ever again, since I am getting older and don’t have the energy to maintain the buildings. When the fire happened, I had the water shut off in both buildings.
Since then, I have continued to receive bills from the City of Chicago for water usage. I know the water has been shut off at both buildings. When I call the water department, they’re not sure why I would be getting charged if there’s no water being used.
I never seem to get anywhere. Plus, I have a rotary phone, so when they say, “Press 1, press 2,” I can’t get anywhere. You cannot talk to a person, only recorded messages. Please, please help!
Barbara Sowa, Chicago
Dear Barbara: Your desire to have no water apparently confounded someone in the water department, and their attempt to straighten it out was what caused this problem. More on that in a sec.
Team Fixer’s first thought in tackling this was that someone was breaking in and taking illegal showers in your buildings. But inspections showed no burglaries and no indication the water main was turned on.
One of your building’s bills started with a 23-cent credit in July. But in September, the charges started, eventually growing to $225.65 in February.
The other building’s bill stayed at $40.
The office of outgoing 19th Ward Ald. Ginger Rugai helped connect us with Gary Litherland in the water billing department. Litherland looked into your problem, and told us the $40 charge was for turning off your water. However, because of your trouble, they have waived that fee for you.
The other bill was more mysterious. According to Litherland, the automatic monitoring system on your water meter indicated zero usage for the period in question. A city employee, upon seeing this, thought it must be an error. That person then overrode the automatic system and added estimated charges.
It’s since been sorted out. They’ve adjusted the bill and you wound up with a credit of $37.30 (and total savings of $302.95). You can either get a check or transfer the credit to another account.
Spring cleaners, take note
Devon Bank, West Ridge Chamber of Commerce and West Rogers Park Community Organization will co-sponsor a Paper, Computer, Electronics and Cell Phone Recycling Event from 9 a.m. to noon this Sunday in the Devon Bank parking lot, 6445 N. Western.
Contributing: Mike Nolan and Carole Sharwarko.
Getting the runaround over a consumer problem? Tell it to The Fixer at suntimes.com/fixer, where you’ll find a simple form to fill out. You’ll also find a list of consumer contacts and tips. Because of the large volume of submissions, The Fixer can’t personally reply to every problem. Letters are edited for length and clarity.