One Bronx resident recently learned her insurance company, Empire Empire BlueCross BlueShield, would cover the costs of her much-needed surgery after struggling to get it approved with them. NY1's Susan Jhun filed the following report.
Recent test results have Miriam Levenstein concerned about a large mass growing on her ovary.
"The doctor said that it does have the potential to burst, it has the potential to twist," Levenstein said.
It's a condition that Levenstein's doctor determined required immediate surgery.
"He said, 'We're going to schedule the surgery, this has to happen, and we'll get insurance approval.' I'd say within that week, I did get a call from the physician's office saying that we were all set to go," Levenstein said.
Then, out of the blue, Levenstein said her physician's office called to say that none of her medical bills related to her surgery would be covered due to contract negotiations between her insurance company, Empire BlueCross BlueShield, and her doctor's hospital.
Even when Levenstein tried to do what her insurance company asked, which was to find another doctor who worked with a different hospital, she still came up short.
"We attempted for almost three hours, and the representative who got on the phone with me said we're having technical difficulties," Levenstein said. "It's very hard not to feel like you are getting the run around constantly. It's also very hard not to take it personally. You know, this is my health, my body, and it's a fight. You know, you pay these very large premiums."
Once Levenstein reached out to NY1 for You, we contacted Empire BlueCross BlueShield. After looking into her case, a representative told NY1 for You that Empire decided to approve Ms. Levenstein to continue seeing her surgeon to get the services she needs for continuity of care. They let Levenstein know and thanked NY1 for bringing it to their attention.
It was a relief to Levenstein, who's anxious to get the medical care she needs.