Complaint Review: aflac - piittsburgh Pennsylvania
- aflac piittsburgh, Pennsylvania USA
- Phone:
- Web: www.aflac.com
- Category: Health Insurance
aflac run-around piittsburgh Pennsylvania
*Consumer Comment: Agree with Ken on this one...
*Consumer Comment: If, after reading your policy with them...
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I signed up for Aflac in the event that I had to have hip surgery, which, it turned out, was the case. After the surgery, I filed for the Aflac benefits for which my policy was written and only three and one half months later, I got a check for way less than the Aflac sales rep indicated. I have now called three times and each time, there is some reason that they cannot come up with a good basis to keep from paying anything else on my claim. The latest one is that I have an inpatient benefit on the policy and an outpatient anesthetic benefit. Their analysis has figured out that the final bill from the hospital indicated that I was registered as an inpatient,for my hip replacement surgery. However, I did so well after surgery, that I was discharged, late in the afternoon of the same day that I had my hip replaced. Since I did not actually stay overnight, then Aflac determined that I was qualified for the inpatient benefit. And since the bill indicated that I was registered as inpatient, I did not qualify for outpatient anesthetic benefit, since the bill did not indicate that I was registered as an outpatient. Their logic is that, since I was not registered as an outpatient, that I clearly did not have ANY anesthetic for my total hip replacement.
This report was posted on Ripoff Report on 03/25/2014 12:51 PM and is a permanent record located here: https://www.ripoffreport.com/reports/aflac/piittsburgh-pennsylvania-15222/aflac-run-around-piittsburgh-pennsylvania-1133523. The posting time indicated is Arizona local time. Arizona does not observe daylight savings so the post time may be Mountain or Pacific depending on the time of year. Ripoff Report has an exclusive license to this report. It may not be copied without the written permission of Ripoff Report. READ: Foreign websites steal our content
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#2 Consumer Comment
Agree with Ken on this one...
AUTHOR: RunswithScissors - ()
SUBMITTED: Sunday, April 13, 2014
I would investigae this and if you find Aflac has indeed 'scammed' you, then report them.
HOWVER, I truly doubt that is what happened. This is not Aflac' s fault, it is your health insurance company, and the hospital.
Let me tell you a story of my own:
I had to have surgery about 4 years ago. I was in the hospital for 5 days. I also have the Aflac Hospital plan; I asked my agent to help me with the claim, which she gladly did. Guess whta the hospital did? They billed my ENTIRE FIVE DAY STAY AS "Out-Patient."
I was floored. Thankfully, I have a really good Aflac agent; she fought for me, and Aflac paid the claim.
You should be aware, however, that hopsitals are under tremendous pressure to reduce in-patient costs. The way they do this is with some shuffling of numbers. What is OBVIOUSLY an "in-patient" stay is recorded and billed as "outpatient." This way the hospital can tell its board of directors (and the state and/or Feds, if they are receiving money from the government) that they have successfully reduced expenses throgh "cost-cutting measures, and utliziation reviews." What a bunch of hogwash. All they are doing is putting the numbers in a different column.
As I stated, a good Aflac can get around this, and WILL get your claimn paid. Don't give up hope!
#1 Consumer Comment
If, after reading your policy with them...
AUTHOR: Ken - ()
SUBMITTED: Tuesday, March 25, 2014
You find they've violated its terms, report it to your states insurance commissioner. If they didn't, guess you'll have to suck it up.
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