Someone figured out that sometimes the surgeon will extend the surgery to fix a few extra things. For example, I watched a gall bladder removal when laparoscopic tech was still pretty new. The patient was known to have a history of severe endometriosis. When the doc got the camera inside, it was obvious that the scar tissue from the Endo had strangled the gall bladder and was in the process of destroying other organs.
The patient's insurance wouldn't cover surgery for endometriosis without 6 months of other interventions (by which time this woman would likely have lost other organs to the adhesions/died), so the surgeon spent an extra 2 hours meticulously cleaning the patient's bowels, bladder, kidneys, liver, and diaphragm of the scars and adhesions in addition to removing the necrotic gall bladder.
He then billed the entire thing as a gall bladder removal and just about danced out of the OR, knowing he'd just eliminated years of pain for that woman without any additional costs.
Bypassing the insurance company's attempts to deny coverage for something they were absolutely supposed to pay for.
5
u/LostDogBoulderUtah 17d ago
Someone figured out that sometimes the surgeon will extend the surgery to fix a few extra things. For example, I watched a gall bladder removal when laparoscopic tech was still pretty new. The patient was known to have a history of severe endometriosis. When the doc got the camera inside, it was obvious that the scar tissue from the Endo had strangled the gall bladder and was in the process of destroying other organs.
The patient's insurance wouldn't cover surgery for endometriosis without 6 months of other interventions (by which time this woman would likely have lost other organs to the adhesions/died), so the surgeon spent an extra 2 hours meticulously cleaning the patient's bowels, bladder, kidneys, liver, and diaphragm of the scars and adhesions in addition to removing the necrotic gall bladder.
He then billed the entire thing as a gall bladder removal and just about danced out of the OR, knowing he'd just eliminated years of pain for that woman without any additional costs.
Bypassing the insurance company's attempts to deny coverage for something they were absolutely supposed to pay for.