intothewest
Registered User
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- 22
Someone said to me on the general issue of confirming cover before the procedure, that they would have let the people in the Hermitage take care of that. Is that correct? And if the Hermitage got the ok from the insurance to say that they would be paid, it's now their problem, not ours. But am I right that this doesn't happen? That it's up to the patient to find out all of this in advance?
I contacted them today, and they are saying the former plan did not cover that operation.
Someone said to me on the general issue of confirming cover before the procedure, that they would have let the people in the Hermitage take care of that. Is that correct? And if the Hermitage got the ok from the insurance to say that they would be paid, it's now their problem, not ours. But am I right that this doesn't happen? That it's up to the patient to find out all of this in advance?
OMG - thank you so much. It's info like this I need to hit them with. No be honest, we really thought it was covered, checked and there was nothing said to us that it wasn't. Said they had to call us back and said they rang, but don't remember seeing a missed call. Early last week I asked for a copy of that webchat, and I still have to receive it. I've learned since to save those webchats. I'll know for again.When comparing the two plans on the hia comparison tool -
it states several times for the one plan 150 -
No cover for listed cardiac and special procedures in the Hermitage and Galway Clinic
It doesn't state what exactly are the special procedures are for the VHI
One Plan 150 -
Covered; €150 excess (payable only on the first 2 inpatient claims per member per policy year) except: 60% cover for certain orthopaedic and ophthalmic procedures, no excess.
No cover for listed cardiac and special procedures in the Hermitage and Galway Clinic
The link above does state the special procedures for irish life and there is no mention of any gallbladder procedures
So it looks like theres a chance they're wrong, but proving that is hard
OMG - thank you so much. It's info like this I need to hit them with. No be honest, we really thought it was covered, checked and there was nothing said to us that it wasn't. Said they had to call us back and said they rang, but don't remember seeing a missed call. Early last week I asked for a copy of that webchat, and I still have to receive it. I've learned since to save those webchats. I'll know for again.
So it got rejected. It was with one section for review, and they said they reviewed the tapes etc, but I haven't received them yet to listen to them all. Once it was still deemed as rejected with them, and we weren't happy with that decision, it was sent by them to their complaints dept for review. Sick at the thought of it now.What is the situation now - are they billing you , the hospital billing you?
How have you gone about the appeal?
irishlifehealth
privacy-and-legal/schedule-of-benefits
- it won't allow me to post the link
They said they called back on 26.06, but I don't recall a missed call.
I contacted them today, and they are saying the former plan did not cover that operation.
Someone said to me on the general issue of confirming cover before the procedure, that they would have let the people in the Hermitage take care of that. Is that correct? And if the Hermitage got the ok from the insurance to say that they would be paid, it's now their problem, not ours. But am I right that this doesn't happen? That it's up to the patient to find out all of this in advance?
Different insurance company so they said it's irrelevant.
read the article there -
shorturl.at/fguxP
Is that an Irish Times article, can you post the full link please?
search for - it won't allow me to post any links
Cover or no cover: ‘I know mistakes happen . . . but it really is a mess’
Pricewatch: Reader shares her experience of conflicting phone calls with Laya Healthcare
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