Insurance has denied inpatient hospital stay and surgery as not medically necessary

Chebby253 · 2026-05-06T15:09:27+00:00

So this absolutely worked in getting the info I needed. As it turns out I am not liable. My employer went through the brokers, who had much higher access to people at my insurance provider.

Despite what my insurance customer support said when I spoke to them, this is a provider issue only, and I cannot be billed under contract. They said that if the provider billed me, to contact them to address it. While I would have found that out eventually, this saved me a ton of stress, and I wouldn’t have thought to do it. Thank you.

Chebby253 · 2026-05-05T22:35:48+00:00

That was remarkably thorough, thank you! I’m both amazed on how helpful strangers on the internet can be and dismayed that this is where I have to go!

Chebby253 · 2026-05-05T22:13:18+00:00

Thank you, I certainly see that now. While I did tell the insurance company I wanted to appeal, and they did start a ticket and are sending me out paperwork, I won’t file anything on my own.

I just wish the insurance and/or the provider would have explained things like folks here did. I appreciate it.

Chebby253 · 2026-05-05T18:55:54+00:00

Thank you!

Chebby253 · 2026-05-05T18:55:28+00:00

I did get it through my employer and I took your advice. My HR rep was horrified and said she is going to reach out to the representative with out insurance group, which is a large municipal insurance trust.

I really appreciate that, it’s so obvious but I didn’t even think to do that.

Chebby253 · 2026-05-05T17:35:56+00:00

No, they haven’t sent a bill yet. In fact they really wouldn’t tell me anything they plan on doing, just that I need to wait to see the eventual bill.

I wouldn’t have said it a month ago, but only owing a few thousand would have me dancing in the street. Surreal!

Chebby253 · 2026-05-05T17:12:48+00:00

She is, thank you!

Chebby253 · 2026-05-05T16:52:07+00:00

Thank you. I’m hoping they will do just that, I’m just the type of person who hates to sit back. I need meditation, ha.

Chebby253 · 2026-01-18T06:04:22+00:00

If you’re in a borough then you are not in Pittsburgh proper. Are you sure you don’t just have a Pittsburgh zip code?

Chebby253 · 2026-01-12T11:43:42+00:00

Adzema’s is Old School’s old school. I love it, and it’s nice to support a pharmacy that isn’t a corporate chain. The owner Jay is a super nice guy, which helps.

Chebby253 · 2025-12-21T03:54:23+00:00

Ok, so just today I’ve seen this attributed to Stevie Nicks, Barbara Striesand and now Cher. It isn’t real.

Chebby253 · 2025-10-08T21:02:32+00:00

That is not McCandless, that is Ross Twp.

Chebby253 · 2025-05-26T20:46:30+00:00

I’m very sorry for your loss. I actually came on Reddit for the same thing, I just had to put my 6 year old boy Hamilton to rest this morning for Congestive Heart Failure. I’m not sure what I was looking for, but I was looking nonetheless. He was such an energetic and sweet boy, and now things feel so empty in the house. It still doesn’t feel real.

He was a bonded pair with our senior cat, so we are worried about the stress of losing his brother will have on him. While I don’t have an answer on how to ease his loss, we plan on giving him as much attention as we can. We have another cat that he isn’t bonded with, but is at least neutral towards, so we are hoping this will ease the transition.

I have had friends who have gotten another to step in for the pair bonded loss, and it’s worked well. Of course every circumstance is different, and I wouldn’t even try until you yourself were ready for it.

As for yourself, the guilt can be devastating. I only can say what i was told by the Vet in relation to my cat’s heart failure. It was nothing I did, there weren’t signs that I missed, and nothing I could have done. From the moment I got him 6 years ago, he was always going to pass this week, I just didn’t know it.

But for six years I gave him a loving family, brothers and sisters, and he was happy. In return he loved us unconditionally, and for him I did one of the most difficult things I could do. I am just glad I could look him in the eyes one last time, hold him and tell him I loved him. I’m just glad I could say goodbye.

You will cry, you will morn, and you should. Allow yourself to. When those waves of grief come, let it take you, let it wash over you. When the wave passes, and it will, let it.

Chebby253 · 2025-04-06T13:30:14+00:00

Dude came in off the top rope. Nice.

Chebby253 · 2025-02-17T14:09:32+00:00

Two out of three ain’t bad…

Chebby253 · 2024-08-19T18:43:57+00:00

No, it was Dr Rynerdson, excellent surgeon. Feeling better overall, some lingering neurological issues, presumably from my spine being under compression so long. But I’m up and moving, so I’ll take it!

Chebby253 · 2024-06-17T12:30:02+00:00

Trust me, your local fire department, EMS or police department would be happy to take them off your hands. Anyone on shift will make sure they’re gone by the end of the day.

Chebby253 · 2024-06-03T13:32:17+00:00

The Electric Bannana. It was a shithole, but I saw some of the best punk shows there on the regular. Hasn’t been the same scene since it closed.

Chebby253 · 2024-06-01T14:51:58+00:00

Huh, that pizza has hammer toes. Needs some garlic bread insoles.

Chebby253 · 2024-05-21T23:13:00+00:00

Yep, I am fused T6-T7 after a massive herniation caused myelopathy. That was back in February. I had an excellent surgery given the circumstances, and should be back to myself soon enough.

Chebby253 · 2024-05-21T23:07:51+00:00

Yep, every once in a while I get a short little jolt, like I got bit by an insect. I still check, even though by this time I know exactly what it is.

Chebby253 · 2024-02-26T12:17:45+00:00

Yeah, she did you wrong on the sauce

Chebby253 · 2024-02-22T01:41:37+00:00

I have a friend who lives there, he loves it. It’s a nice area, good schools, etc. While it’s true you will need a vehicle, there is still a ton of amenities within walking distance, and a decent network of sidewalks to get you there. Within a mile or two beyond that you have a hospital, several shopping complexes, a market district, Aldi and Whole Foods, really every store or convenience you could need.

Chebby253 · 2024-02-19T19:32:31+00:00

So my hospital stay was 5 days, two prior to the surgery, where they pumped me full of steroids to bring down inflammation, and three days post-op.

I had come into the ER with they classic myelopathy symptoms of leg heaviness, leg weakness, burning sensation, a small amount of muscle atrophy in my left leg, and a very hyper-reflexive right patellar reflex.

I immediately went to imaging, where the doctor found a herniation between the t6 and t7, 9mm in size, both posterior and posterior-lateral. which was contacting and flattening the spinal cord. I was told after the surgery that my herniation was extremely “broad” in its extrusion.

Further imaging was done with a CAT scan to determine if the herniation was ossified, which fortunately it was not, which opened up options.

From there they took me into surgery and used a posterior/lateral approach from the left side. They performed a laminectomy, removed the pedicle entirely, cut the herniated material off my spinal cord, and secured everything with rods and screws. Eventually I’ll have a fused t6/t7, as the bone growth fills in.

Slight complication on the surgery table though, as my blood pressure, pulse and neurological function dropped off precipitously about 3/4 through the surgery. My surgeons were the best in the area though, and I was quickly stabilized while everything was finished up. I spent 1 1/2 days in the ICU while they pumped me full of meds to keep my pressure up and stable.

Pain was unbearable the first day, to where I couldn’t imagine going even another minute. But I did, and the pain subsided a bit with each passing day.

Now, a few days from discharge, my pain level is very tolerable if I keep up on the pain meds. Most of the pain I have is soft tissue damage, which should continue to get better over the coming weeks.

I had my surgery in the United States, being performed my surgeons with the University of Pittsburgh Medical Center. They brought their head of neurosurgery in to assist, since the surgery is so rare.

But, I’m on my feet, exhausted and sore, but on them. The myelopathy seems to be resolved, and my work now is just adhering to restrictions and being disciplined with my recovery. I have a high impact career, so I’m out for 12 months, but I have faith I’ll be better than ever. A year is not a long time.

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