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Woman has surgery delayed by insurance company – pre-cancerous condition listed by dermatologist

Posted Apr 12 2009 11:51pm

This is pretty serious stuff, when having to delay a mastectomy for 2 months until the insurance company reinstated her insurance.  Once word, by a image dermatologists in the chart cancelled her insurance.  All of this happens when people at at their weakest moments and need surgery, and yet if in this case if she had cancer, well that’s a delay of 2 more months for it to grow and potentially spread.  

When running automated data queries that bring up red flags as such, does anybody investigate or does the process continue and the processes run on an automated system?  I’m guessing this might be part of the problem here, but 2 months to clarify?  Also, nice to know she was notified 2 days before her scheduled surgery.  I don’t know about you, but the surgery is stressful enough and then add this to the battle.  BD  

Two days before the Waxahachie woman was scheduled to have a double mastectomy, she got a phone call from her insurance company.

"My chart had been red-flagged," said Beaton, 58. "When I went to the dermatologist he put down a word that meant pre-cancerous. He was the reason I got my insurance canceled."

Though her insurance was reinstated with help from U.S. Rep. Joe Barton, R-Arlington, her surgery had to be delayed two months. The experience inspired Barton to propose a federal amendment that would give patients the right to appeal a decision to drop their insurance.

Now the state Legislature is looking at the issue.

Legislation filed by Sen. Eliot Sharpleigh, D-El Paso, could protect consumers from the fallout of rescission. One bill would require insurance companies to cover family members if a policy is canceled

Bills would protect patients from canceled health insurance | Health |

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