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Jane Doe Deer
Jane Doe Deer, Attorney
Category: Consumer Protection Law
Satisfied Customers: 3896
Experience:  Attorney since 1986; Plain English explanations; Scams, cons. protection, etc.
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In July I saw a plastic surgeon to perform a breast reduction.

Resolved Question:

In July I saw a plastic surgeon to perform a breast reduction. This doctor was recommended by my gerneral practioner whom I've seen for 15+ years and trust very much.

I contacted my insurance company and was told this type of procedure was covered under my plan and my annual deductible had been met and should have no out of pocket expense.

It was surprising to me to find the surgeon asking for payment in full prior to the procedure and his office would courtesy bill my insurance for me even though I had received pre-approval.

I was told it would cost $12,000 and hesitantly paid figuring I would have the money returned. Not the case.

I rec'd a check from the doctor for $1400.00 stating this was the amount of overpayment.

He had charged my insurance company $17,000.00 on one claim under Pacific Surgery and $4200.00 on another claim in his name of which he received $15,000. So in total receiving $27,000.00(12k/me + 15k/insurance) - $1400.00(refund to me).

On top of that I had a very bad reaction to the anestesia. I became extremely depressed and disoriented. The recovery room nurse told my husband she was fine when she came in before her surgery "Is she always this depressed?" My husband said, "NO." The nurse said take her home and let her sleep it off I have to get out of here to an appointment.

It did not get better it got very much worse. I became almost deliarious and my husband had to call 911 and was taken to the hospital as a crazy person.

The doctor took no responsibility at all.

I feel violated in so many ways it is uncomprehensible. Is there anything I can do TO MAKE SURE this does not happen to someone else?
Submitted: 6 years ago.
Category: Consumer Protection Law
Expert:  Jane Doe Deer replied 6 years ago.

 

Thank you for contacting Just Answer. I look forward to assisting you.

 

While we write back and forth, please keep in mind that I do not know what you already know or don't know, or with what you need help, unless you tell me. Sometimes I'm unable to read your entire question until AFTER I write back to you.

 

Although it's usually five minutes, sometimes there can be a delay of an hour or more in between my answers because I may be researching the answer to your question, helping other customers, or taking a break. If we are writing late at night, I may have to go to sleep and resume helping you the following morning.

 

I need the following information before I can answer your question:

 

 

Answer: Thank you for being a loyal JA customer. I'll do my best to help you.

 

Here are several options for you to pursue, in no particular order.

 

1. Call other doctors' offices and find out how much a similar operation would cost there. Take copious notes.

 

2. File a complaint with the CA Consumer Protection Office: http://ag.ca.gov/consumers/general.php

 

3. File a complaint with the CA office, board, or commission that licenses doctors. I don't have that link handy, but Consumer Protection can help you.

 

4. Meet with at least two personal injury attorneys for in-office consultations about suing (1) for personal injury and (2) for return of funds that you paid.

 

Here are two starting places for finding attorneys:

 

 

http://www.caoc.com/ca/index.cfm?

 

and also the state bar's website:

 

http://www.calbar.ca.gov/state/calbar/calbar_generic.jsp?cid=10182&id=1403

 

Don't actually HIRE an attorney without first checking references. And don't try to pick the attorney's brain on the phone. Schedule an appointment and visit the office, like you would for a doctor!

 

5. Schedule a consultation with your own doctor to discuss what happened, and see if he or she has additional suggestions.

 

In addition, please be aware that breast reduction surgery for one's health usually IS covered by insurance. It's possible that you will have to ask for a hearing from your insurance company. If so, you may want to have an attorney represent you - or AT least, help you prepare by reading your contract, etc. In addition, you can also file complaints against your insurance with Consumer Protection and the board or commission that licenses insurance companies in CA.

 

There is also a federal agency for filing complaints: ftc.gov

 

I'm happy to answer follow-up questions. I'll be working all day Sunday. All you have to do is just write back!

 

 

If you have none, please

"ACCEPT" my answer.

 

There can sometimes be a delay of an hour or more in between my followup answers because I may be helping other customers, conducting legal research, or taking a break. If we're writing late in the evening, I may need to get some sleep and resume helping you the following morning.

 

Bonuses of even a dollar are much appreciated and help support this site.

 

 

I REALLY appreciate FEEDBACK so that I can continuously improve!

 

All my best,

 

Jane Doe Deer

 

 

 

 

 

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