I've read several of the comments on-line here. I, too, have had an experience with LSI in Tampa. LSI was very nice and insistently helpful in the beginning. I was initially told my surgery would be around $65,000 , but I would only have to pay $30,000 up front, as this is the amount insurance would pay me back and they accept that, but my insurance would be paying them and then they'd refund me.. When I was being admitted and handing over my $30,000 payment, my husband and I had questions one regarding if the pre-certification was taken care of, etc. We were assured that it was all taken care of. As that is the way all of my many other procedures were handled, I, trustingly, believed them. (much later when questioning the amount insurance paid, they decided to tell me this surgery didn't need precertification If that was the case, I would have verified with the insurance!!) Again, when we began asking questions, the patient advocate left and came back stating they've decided I didn't need that surgery, just this other one and it was only $17,000 they would get us a refund for the balance of our check I just handed them. More blah, blah, blah and suddenly it was changed back to the $65,000/$30,000 surgery.
I was seen by 3 physicians the 1st insisted I needed injections. I tried to explain to him I believed I had already had those he pretty much patted me on the head and said, Now who is the doctor here? I was prepped for the injections when an assistant read my files and asked me, Haven't you already had injections? I said, yes, I think so. She got up and conversed quietly with another doctor. He came over and changed my diagnosis and what procedure (surgery) he felt I needed. For some reason, another doctor became involved and changed my diagnosis, again, to involve a, yet, 3rd different surgery. I was getting a little nervous at this time, but went through with it.
What a surprise it was when I was only reimbursed around $6,000. I, too, as many others did, tried e-mailing and calling them, just to be ignored. When they did answer at times, they did not address my actual concerns. The surgery didn't work and they were to get with my pain clinic doctor to try to find out what the problem was and try to remedy this. No contact was made, of course. I called and e-mailed several times letting them know they haven't gotten back to me about the failed surgery I was contacted and told, again, they'd get back to me.
When I started complaining and telling them I was going to have to seek help with this entire problem from other sources, I suddenly received a check for several thousand dollars. But that still left over $10,000 that we are out. I have sent appeals to Anthem, as I couldn't get LSI to do anything for me, but, apparently, LSI's charges are way out of line and what was reimbursed to me is it (LSI is, of course, not in-network). Also, LSI strung me along for months saying they had filed and refilled appeals for me when I find out they can't even file it'I have to! In yet another e-mail, I summed up my whole visit with LSI and demanded to speak with someone higher up could not get LSI to respond to this, either. We have been dealing with these people for well over 2 years. I can not get them to just fess up and say that I'm SOL. I have 70 e-mails, along with numerous phone calls. It has been suggested to me to contact the American Medical Association, the Better Business Bureau and/or an attorney. Has anyone had experience doing something like this? Sorry for the long scenario, but I just wanted to get my story out there. Needless to say, this stress has played havoc on my well-being, along with my major back pain. Any advice anybody???