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  1. KarenK

    For those who went to the Cleveland Clinic… did they do this to you?

    I would expect to sign a doc saying that I was responsible for charges not covered by the ins. co. If all had been going smoothly with the CC I would not have had a problem signing it but the CC's misleading, conflicting behaviors and their failure in filing appeals and then lying to me about...
  2. KarenK

    I now think my ins. denial was due to the Cleveland Clinic, not Humana.

    Yesterday I got a copy of a poorly prepared partially completed appeal that’s certain to be denied. 1st - No required Appointment of Representation form. 2nd - Where it asks for the specific medical service for this appeal it only states “aortic valve replacement”. There’s no mention of TAVR or...
  3. KarenK

    Anyone beside me having issues with the Cleveland Clinic? Cancelling my surgery

    The estimate I received only included the surgeon and no one else. Others to bill independently, don’t know who the are, nor if they take my insurance
  4. KarenK

    Anyone beside me having issues with the Cleveland Clinic? Cancelling my surgery

    The insurance is Humana Choice PPO Medicare Advantage Plan. Actually I have been remiss in not stating more often who the ins. co. is so others hopefully do not fall into the same situation. United Healthcare is just as bad, worse in some ways and I think they are the largest insurer in this...
  5. KarenK

    Anyone beside me having issues with the Cleveland Clinic? Cancelling my surgery

    When were you at the CC? Absolutely nothing you said describes the CC today. The CC's documents states "providers are NOT contracted with or employees of the CC" and you will received separate bills for surgeons, radiologist, anesthesiologist, pathologist, etc. as well as for services eg...
  6. KarenK

    For those who went to the Cleveland Clinic… did they do this to you?

    May I ask what company your MC Advantage plan is with?
  7. KarenK

    For those who went to the Cleveland Clinic… did they do this to you?

    The CC is in network. The problem is Medicare Advance is not Medicare. They are greedy corporations all about the $$$ so they wrongfully deny coverage. There are changes in the works on how these companies promote themselves but nothing is being done that I’m aware of about their improperly...
  8. KarenK

    For those who went to the Cleveland Clinic… did they do this to you?

    My Medicare denied my surgery stating the I'm "not very severe" (I guess that means critical) and I do not have congestive heart failure (so I have to incur more heart damage first). Yes I can go back to original Medicare, however you normally can not get a supplement plan unless you signed up...
  9. KarenK

    For those who went to the Cleveland Clinic… did they do this to you?

    i never said I didn’t have the means to pay. And they have ways of collecting. Payment plans, liens, etc. They might be thinking I have deeper pockets then a Medicare plan and that’s why I was mislead and they didn’t follow through with appealing my insurance denial.
  10. KarenK

    For those who went to the Cleveland Clinic… did they do this to you?

    I misspoke when I wrote about the ins. denial. The ins. co. said there has been no activity since the original denial. They did mail a document stating the reason for the denial... I was not "very severe" (critical?) and I was "not in congestive heart failure". It is so much harder for...
  11. KarenK

    For those who went to the Cleveland Clinic… did they do this to you?

    W CC admitted they did NOT have approval. Humana’s ins. may be lacking but they have excellent customer service with whom I spent over an hour on the phone as they did everything they could to find out the why it still says denied. I then emailed the CC and requested that they forward the...
  12. KarenK

    For those who went to the Cleveland Clinic… did they do this to you?

    Hi Chuck, You are so very helpful, it is greatly appreciated! It certainly is a stress inducing and confusing time. You are giving me more confidence in signing that document. But what complicates the situation for me is the CC misleading me on the urgent ins. appeal that they never did...
  13. KarenK

    Need your opinion on these echo results... not trusting my doc.

    Hey Chuck, 90%+ genetic, that's surprisingly high. As of this point I don't know if the rest of my siblings have been tested or even made the connection that this might be an issue for them. I separated myself from that unhealthy situation a few years ago but I do need to give them a heads up...
  14. KarenK

    For those who went to the Cleveland Clinic… did they do this to you?

    In 2 days I’m supposed to be flying to the CC, BUT how I have been treated is unlawful and unacceptable. I feel like I have been badgered by a number of people in the Surgeon’s office and in Surgical Registration. They all say one thing about the financial arrangement but they won’t put it in...
  15. KarenK

    Need your opinion on these echo results... not trusting my doc.

    Wow, thanks Chuck! I think you are absolutely spot on. I had never even heard of Lp(a) until now. There is a familial severe hypercholesterolemia at play here. I had my first cholesterol test at age 30. They couldn't tell me how high my cholesterol was because their equipment didn't go that...
  16. KarenK

    Anyone beside me having issues with the Cleveland Clinic? Cancelling my surgery

    dick0236 The CC actually stated, "it would be illegal" to have a document of the agreement in writing. Unbelievable. No local surgeons for me. My sister had SAVR locally and went from the hospital into a rehab facility and died a short time later. Arkansas is rate 49 out of the 50 states...
  17. KarenK

    Anyone beside me having issues with the Cleveland Clinic? Cancelling my surgery

    My ins. denied coverage. CC did an urgent peer-to-peer appeal. CC called when the urgent appeal was to be completed, said it was denied and ins. co. won’t respond again until 11/2, surgery is 10/24. So we’re in the 2nd level of appeals. CC said my case was submitted to the powers that be and...
  18. KarenK

    Low hr/bradycardia months/years following surgery

    Your story sounds like my father’s up until the night his 2nd degree turned into 3rd degree. It was a rush in the middle of the night to the ER with no cardiologist or doctor of any type there. The only doctors were on call. His heart rate was down to 14. The staff on duty blamed it on faulty...
  19. KarenK

    Cleveland Clinic just called. Wanted to schedule surgery for next week!!

    My issue with asking a dr. is trusting that they will they tell you the truth. They may have motivations to overstate or mislead you. I have been mislead on more than one occasion in the past.
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