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United American Insurance Company When would you think that a rattlesnake bite is not an accident? McKinney Texas
I had an accident (or what anyone in their right mind would classify as an accident) on June 8th, 2008. While weeding around the roses in my garden I thought that I had been poked by a rose thorn when actually, I was bitten by a baby rattlesnake that was hiding in the weeds at the base of the rose bush. I was driven to the emergency room at our local hospital where they administered potentially life-saving anti-venin.
According to their newly instituted hospital Rattlesnake Bite Protocol, after the anti-venin was administered I was admitted to their Intensive Care Unit for further administration of anti-venin as well as vital sign and blood coagulation monitoring. The total bill for 27 hours in the hospital was $73,000.
United American has paid $3,000.00
I had been sold the United American Flex-Plan as a replacement to a Blue Shield policy that I had paid for through Cobra after retiring from my job. I was assured that I was receiving a plan that was equivalent to the plan I had been on. Had U/A the negotiating ability of Blue Shield, the bill would have been reduced a small percentage of this bill. As it stands, I am now working through hospitalvictims.org to get the billing reduced.
In the words of Dawn Mitchel, one of United American's Health Benefits Division Workers, their policy is supposed to be "providing valuable protection against the unexpected expenses of illness or injury".
What would qualify for that better than a Rattlesnake bite?
Laura
Chico, California
U.S.A.
7 Updates & Rebuttals
Stacey
Dallas,Texas,
U.S.A.
Roger are your serious??
#8Consumer Comment
Fri, March 06, 2009
I work for a company that owns Hospitals
I read soo many complaints about overcharging, price gouging, Doctors who over charge, etc etc
Any trip to the ER is going to cost money - there are people who crowd the ER with non emergencies ie: the flu, a common cold, stomach pains yet have to be seen because that is the law
Do you honestly think that the Hospitals should eat the costs of the non emergencies vs the real emergencies???
A rattlesnake bite is an emergency - therefore factor in anti-venom, the personnel who attend to the individual, other medications needed and all other medical costs associated with treating this type of emergency - It does get expensive
Hospitals have to pay personnel, vendors, lighting and heating, property taxes and liability insurance for people who think it is OK to sue because they think they got a raw deal and I guarantee we get sued as most other companies that own hospitals do
Welcome to the 21st Century - If you do not like the Hospital system then too bad - call your State Rep and voice your concerns
Stacey
Dallas,Texas,
U.S.A.
Roger are your serious??
#8Consumer Comment
Fri, March 06, 2009
I work for a company that owns Hospitals
I read soo many complaints about overcharging, price gouging, Doctors who over charge, etc etc
Any trip to the ER is going to cost money - there are people who crowd the ER with non emergencies ie: the flu, a common cold, stomach pains yet have to be seen because that is the law
Do you honestly think that the Hospitals should eat the costs of the non emergencies vs the real emergencies???
A rattlesnake bite is an emergency - therefore factor in anti-venom, the personnel who attend to the individual, other medications needed and all other medical costs associated with treating this type of emergency - It does get expensive
Hospitals have to pay personnel, vendors, lighting and heating, property taxes and liability insurance for people who think it is OK to sue because they think they got a raw deal and I guarantee we get sued as most other companies that own hospitals do
Welcome to the 21st Century - If you do not like the Hospital system then too bad - call your State Rep and voice your concerns
Stacey
Dallas,Texas,
U.S.A.
Roger are your serious??
#8Consumer Comment
Fri, March 06, 2009
I work for a company that owns Hospitals
I read soo many complaints about overcharging, price gouging, Doctors who over charge, etc etc
Any trip to the ER is going to cost money - there are people who crowd the ER with non emergencies ie: the flu, a common cold, stomach pains yet have to be seen because that is the law
Do you honestly think that the Hospitals should eat the costs of the non emergencies vs the real emergencies???
A rattlesnake bite is an emergency - therefore factor in anti-venom, the personnel who attend to the individual, other medications needed and all other medical costs associated with treating this type of emergency - It does get expensive
Hospitals have to pay personnel, vendors, lighting and heating, property taxes and liability insurance for people who think it is OK to sue because they think they got a raw deal and I guarantee we get sued as most other companies that own hospitals do
Welcome to the 21st Century - If you do not like the Hospital system then too bad - call your State Rep and voice your concerns
Tmm33
Yeah That Place,Tennessee,
U.S.A.
actually
#8Consumer Comment
Fri, March 06, 2009
Call the hospital and get a printout sent to you for all costs. Call your insurance company ask them why this is not paid. They will tell you. (sorry I dont know much about insurance companies but I do know i was billed for 200.79 and it was paid in full by my insurance) Hospitals constantly will AND do try to charge you more to see if they can get away with it. As for a life saving emergency then I would frankly call the insurance company and raise hell.
Joy For Today
Moncks Corner,South Carolina,
U.S.A.
FlexPlan Can Work Well
#8Consumer Suggestion
Fri, March 06, 2009
The UA FlexPlan only works well with a good network or network group. I work as an independent agent for Assurecor which acts as a brokerage house for a number of insurance companies, so yes I sell United American products, but I am not "employed" by them.
What makes the FlexPlan work well for our clients is an administrator/negotiator called the National Association for Network Pricing. If a doctor or hospital accepts insurance, they are in one of the networks that belongs to this association. Therefore, you can go to any doctor or hospital 24/7, anywhere in the U.S. - you can't be out-of-network. And yes, everything is negotiated down to that aspirin that the hospital wants to charge you $10 for.
I'm sorry that some people have had the experiences that they did. There could have been a better outcome.
Jabber_up
Denton,Texas,
U.S.A.
Hospital -v- insurance companies
#8Consumer Comment
Wed, January 07, 2009
How do insurance companies work? Hospitals agree to managed care contracts with the insurance companies. For instance: ABC insurance will contract with a hospital to allow patients holding ABC insurance to receive hospital care at the facility that holds the managed care contract, but the hospital must write off most of the costs, anywhere up to 80% of the bill.
If a hospital does not agree to the managed care terms then the insurance company does not have a contract with the hospital. If you, as a patient, visit a hospital out of network, you will be charged up to 90% out of pocket. Your insurance is still billed by the out of network hospital, but without the large write off, the insurance company has to pay the facility a larger amount of money and that is why your insurance company will make you pay so much for out of network care. So if the hospital is not getting ripped off, then you are getting ripped off for using a out of network provider. Hospitals agree to many managed care contracts from insurance companies and usually only receive about 39 cents on the dollar.
Next time you get a physician or hospital bill, look at your explanation of benefits. Notice the 'Provider contract discount' This is the amount the provider had to write off to get your business. The 'Eligible payment amout' is what is left over after the insurance company has determined what percentage they will pay on the remainder of the bill, after they dock you for the out of pocket amount, co-pays and your deductible. This is why people 'always' blame the insurance company.
Roger
Tulsa,Oklahoma,
U.S.A.
Why does everyone automatically blame the insurance company? What about the hospitals?
#8Consumer Comment
Wed, September 24, 2008
There are so many posts that make the insurance company out to be the bad guy. What about the Hospitals? 27 hours and $73K? Sure they provide medical attention and save lives, all while charging 300 to 500% over the cost of their goods. Hospitals will charge an incredibly high rate for many procedures and supplies, hoping that they actually get paid that amount. When an insurance company refuses to pay the outrageous amount, they are blamed. Insurance companies have their rates approved by the state insurance commissioner, hospitals are given free reign to charge whatever they want. This country's health care crisis will never be solved until the cost of health care is put inder regulation just like the insurance companies are. Next time you see a doctor driving around in a 50K+ vehicle living in a 500K+ home, consider that. Sure they went to medical school and have learn a very specialized field, but there should be limits.