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There was a mole that was approximately right there, said Magnuson as he showed the scar from surgery on his calf.A scar that's now a reminder of the ,337.60 bill his medical provider, Aurora Health Care, charged and his insurance, Anthem, didn't want to cover."The surgery to identify the lymph node, the sentinel node, which ultimately had the cancer cells, which raised it from a Stage 2 cancer to a Stage 3 cancer, was not medically necessary," Magnuson explained.Magnuson said it was "extremely shocking."He explained he has been receiving immunotherapy to treat cancer. But at the same time, Magnuson has been trying to get the procedure that identified his Stage 3 cancer covered by his insurance.Magnuson appealed Anthem's decision twice and each time, he said he received a little more of an explanation as to why it wasn't being covered."The closure of the wound was listed as a complex closure, but based on what the insurance company could see, it was a simple closure," Magnuson said."That means nothing to me before and it means nothing to me now," he continued."I had a wound on my leg and they needed to close it," he said.WTMJ reached out to medical billing expert Pat Willis, asking her how common it was for an insurance company and medical provider to disagree on whether a surgery is complex or simple."No. It's not common," Willis said.When Willis reviewed the medical coding used in Magnuson's case, she discovered something."There's no such thing as an 'intermediate complex' code. There is no such thing. Whoever wrote 'intermediate complex,' that does not exist. It's either 'intermediate' or it's 'complex.' It's not both,” Willis continued.The wording of the coding, according to Willis, was incorrect.WTMJ asked Aurora and Anthem in late August to answer our questions about this case. On September 28, an Aurora spokesperson said:"Our top priority is to provide the highest quality care for those we serve. That includes helping our patients navigate issues related to billing and insurance, which we know can be complex. Federal and state laws prohibit us from commenting further on specific cases." Anthem's spokesperson provided the following statement: 2189
Trump also referred to an Indiana-born judge of Mexican descent, who was presiding over a fraud lawsuit against Trump University, as a Mexican who would be unable to rule fairly because of Trump's proposal to build a wall along the U.S.-Mexico border. 251
This restaurant boasts the best old-fashioned in San Diego. You can decide for yourself during this happy hour with half off select cocktails, wine, beer, spirits and small bites. 179
Trump had savored the prospect of a shutdown over the wall, saying he'd be "proud" to force one over an issue that was one of his biggest campaign promises. He had said he wouldn't blame Democrats for a shutdown but now blames them for not contributing to the 60 votes needed for such legislation to clear the closely divided Senate. 333
Thursday night, Union responded saying "I would be honored!!" She tagged the football team to try to make it happen and used the hashtags: #ThereIsNoPlaceLikeNebraska #GBR #Home 177