Did you get pre-authorized for your initial Proph BMX? I know with my insurance.. I have to get pre authorized or I might be on the hook. I get everything in writing, including the pre-authorization

There is also such a thing as “zombie” or “legacy” debt: bills that have been paid and settled, but entire accounts departments sold anyway for pennies on the dollar to collection agencies to intimidate and squeeze more out of a dead case. John Oliver devoted an episode of his weekly HBO show; he (his production company) bought an entire debt collection company, forgave all the debts and then dissolved the company.

You did not post your diagnosis or other breast cancer profile--unless you make that public, it’s impossible to reliably advise you. Did you have a proven reason for having a prophylactic BMX--family or personal history of breast cancer, genetic testing showing a mutation, ethnicity (Ashkenazi Jewish) or any combination of the above? If you simply wanted a prophy BMX and if you didn’t already have any of those factors, you may well be out of luck. You may need to hire an attorney who specializes in these matters--they take these cases on a contingency basis if they believe you were not legitimately billed. But there is a possibility that you may still legally owe enough that bankruptcy or Ch. 13 might be necessary.

hi glc213, FL has an Insurance Consumer Advocate's office. Maybe they can help. Good luck!

Florida's Insurance Consumer Advocate

A Strong, Independent Voice for Floridians

As Floridians become increasingly dependent on quality insurance products, a strong advocate is needed to represent the people when insurance decisions are made. Florida's Insurance Consumer Advocate is an independent leader with an effective and powerful voice for all Floridians.

The Insurance Consumer Advocate is committed to finding solutions to insurance issues facing Floridians, calling attention to questionable insurance practices, promoting a viable insurance market responsive to the needs of Florida's diverse population and assuring that rates are fair and justified.

http://www.myfloridacfo.com/division/ICA/

Hospitals routinely overbill, double bill and incorrectly bill, hoping patients won't notice. This is because they are inadequately reimbursed for personnel and services--they can’t bill for residents, nurses, aides, transporters, etc. (all of whom are salaried), so they make it up by overbilling for tangibles--such as tissues, slippers, aspirin--that insurers do reimburse. Hence the $15 box of Kleenex, the $25 Tylenol and so forth. I know it sounds like a pain, and it might be hard to recall what was actually done & administered way back when, but we need to go over every charge on an itemized bill (and if the hospital won't give you one, demand it) to make sure it was legitimate. For instance, when I was in orthopedic-surgery rehab I was on an opioid painkiller. The nurses had a computerized locked meds cart that had a clock that turned over at midnight--and if you were supposed to get your dose before midnight and the nurse was late, the computer refused to release that dose and you had to wait for the first dose of the new day. It was a case of “use it or lose it." Even if you got your 11:30 dose at 12:05, it was counted as the first dose of the next day and counted as one of the four doses you were allotted the next day. But though the cart couldn't dispense the dose before it was due (so if nurses fell behind they could still administer the pills half an hour late), the dose was still entered in advance into the computer.....and billed. This happened three times during a 14-day stay--and I was billed for six pills I never got. If I hadn't been keeping a diary on my iPad I could never have proven the error.

Another time, when I was still practicing law, I was representing a decedent’s estate, and one of the creditors’ claims was the bill from the hospital where the decedent died. (“Expenses of final illness” are counted as a priority claim). For a two-night stay, the bill was about a third of the entire estate. I thought something was fishy, so I met with the executor who thought so too. For instance, the patient was a double amputee when admitted...but billed for a pair of slippers. We also found numerous duplications and treatments that were never administered. At the first hearing, I told the judge we were contesting the amount of the claim, and he ordered the hospital’s counsel and me to sit down, go over the bill and come up with a settlement. Because I already had a list of suspect items, we were able to cut the claim in half.

If you can pinpoint suspect items and explain why they are bogus, they will almost always be deducted from the total.

I can relate to an hospital bill that was a surprise to say the least. My DH had a colonoscopy in February. His doctor was in network but the facility where he did the procedure was not. We were told by BC/BS we were responsible for the $3000 charge. This had never happened before.
Needless to say we were upset and I made multiple calls to BC/BS and appealed the decision. We lost but I didn't give up. A lady who worked for several doctors for years in the insurance department said call and complain to the doctors office. She said maybe we should have known but she said they should have as well. I did that and we haven't heard a word since then.
A friend was declined coverage 3x before she was successful. They were being charged 5k for the Oncotype test. Her husband finally convinced the insurance company it was medically necessary.
This lady's advice was squeaky wheel gets the grease. Worked for us.
I agree with Sandy about checking your bills. FedEx where I worked used to give rewards for finding mistakes on medical bills. Saved the company a lot of money.
Good luck!

Diane

I thought cancer reconstruction was supposed to be covered by insurance companies. That is what it said in my plastic surgeons office. What state are you in. This sounds crazy. I really dislike insurance companies for this very reason!

i called my health insurance and went through item by item of all the bills i didn't understand.

sometimes there's discrepancies of few dollars....