Hi everyone-
Not sure if anyone on here has tips or went through what I have going on. 7 weeks ago I had surgery on ruptured brain aneurysm & two strokes. Since then, I’ve been paying bills that came in under insurance and very close “max out of pocket” for year. Now I am getting rejections for 4 days of hospital stay (saying not medically necessary & I’m appealing this) and now only $100/$3k being covered on the facility side of radiology (CTs, Doppler’s, MRI, etc)- I already paid physician side of this. I know there are still things coming in. I am still going back and forth with speech recommended by neurosurgeon, as insurance said it wouldn’t cover for aneurysm/ stroke- still working on medical codes with them. Still working on on Getting extension approved on short term disability, it was 6 weeks they gave me, and they wanted to know why I’m not at Work yet. (My work Company approved FMLA for me though! But I’ll be back after 8 1/2 weeks)
Getting through recovery & heading back to work in a week or so since neurosurgeon wanted me driving okay (just given back to me 
) and a few other appointments. it’s hard to get myself focused on me when I’m on the phone all the time getting a lot of this recovered. Tough to get through it all & having a great neurosurgeon to help in way they can with all this but it is another emotion to deal with now. Hope that all wasn’t too much! Anyone on here with tips to get me through these stressors would be appreciated!
HeatherW,
I also had a ruptured aneurysm (Vertebral/PICA) by the brainstem. My NeuroSurgeon and Neurologist Interventionist explain that Leave of Absenced recommended guidelines is 1 week hospitilization = 1 Month of Absence. In my case, it was approx 3.5 weeks so my Leave of Absence was 4 months. They told me that it is minimum guidelance. If I had issues, they would extend the Leave. It turns out that I developed disabilities so I had to go on a Second of Leave of Absence. Short term disability is determined and signed off by your physician (NeuroSurgeon or Neurologist). Your company needs to then approve. There is no financial liability for your company as you probably paid for short term disability in your payroll checks. Depending on the State that you live, your position is protected up to 6 month as in the case of CA. I am not sure with your State. You may want to check with your State Rep to serve as an advocate. Note that insurance is critical. If u had a coiling like me, angiograms will need to be performed to check on the procedure. Those procedures are expensive. Your State Rep office may also serve to work with insurance co. Your hospitilization is determined by your physicians so it is not needless. An rupture aneurysm is life threatening event and those insurance company should be ashamed for taking it lightly. Forward the stats that Bafound or TAAF has on the stats of fatality rates.
Odds are the hosptial stay was coded wrong on the bill, causing the rejection. Everything needs to fall under the original diagnoisic code, including all test and follow ups. Your surgeon’s office may be able to help with this.
You have up to 12 weeks FMLA for your own serious illness, your company has no option but to grant that based on the fact you were in hospital with a stroke. Typically short term disability mirrors FMLA, not sure where that SNAFU has come in where you have one period time on one and a different one on the other. One thing, short term kicks in after you’ve used all your paid time off/sick time. So, depending on how much of that you had your short term may be shorter than 12 weeks.
At the end of day, at the end of 12 weeks, your employment depends on your employer so keep on really good terms with them and keep them advised.
azurelle
I had my surgery Dec 7 2017. My bills were not finally approved by Insurance until Feb 2018. Who knows why. Just make sure you keep track of everything you paid, My hospital and a doctor had to reimburse me for some prepayments they made me pay for surgery. They of course kept the $ until I called them asking where my refund was, and I only just this week got my final reimbursement, 7 months after surgery! It really is a game, and like you said, not one we want to playing during recovery.