[Resolved]  Dr. Agarwal Eye Hospital — Lack of information provided & false hope

Hi,
I recently visited agarwal hospital, alwarpet for my Lasik surgery enquiry. I wanted to know whether am I eligible for insurance claims, counsellor over there said they can facilitate the claim procedure and not the exact conversation attached since, I don't want to bring black mark for the hospital because of one person's carelessness. she said we can do some changes to facilitate the patients.. in that way mine can also be done. The same was conveyed over the phone to the insurance desk. We wete guided to them. Initial procedure were done for the claim, and my claime was approved for certain amount from my insurance side. There again raised a question, I contacted the insurance agent directly and asked y the full amnt wasn't approved. They said only after surgery the enhancement claim will be sent from hospital and that will be processed. So I've again tried to reach the counselor but she didn't answer me someone instead said me that they will call back. Bt then I didn't hear from so I again called the counselor and she said pre-approval got from insurance and post the surgery we will get the claimed amount. So as far as from a laymen perspective, what the counselor sad was, they will send the report with certain diapotre reading, which will be processed through claim prior that I need to pay the rest of the amount for surgery, though I opted for cashless claim. What she spoken was a kind of assurance from their side. Being in a position of trust and customer relationship, everything should be transparent. We the people not usually will know all the loops in insurance etc.. when something is said by a person with authority we tend to trust them. In this case, I was also like..yeah she informed the insurance desk with that details my insurance was processed, so as per my conversation with insurance side. They will send report from hospital and I will get refund. Surgery was done, claim was sent to insurance provider. I was like yeah the counselor said that I have this much power and same reported to the insurance help desk of the hospital and same processed so I got approval, the above said power will be covered by my insurance. Bt nothing went as they said. When I wanted to sort this out with her. She from the frst instant started to defend her, and blaming us telling that we should have reminded them at each and every steps. Is that our job to remind ppl? And also she wasn't the one handled my case fully, she handed over this to someother without any update or proper notice. I spoke with that person he clearly admits that it's her fault. So who should take the responsibility for their action? Finally they said they can do anything for this. If they've said that my insurance wouldn't cover this I would have postponed the surgery. Even they very well know that I postpond some of pre surgery tests to get confirmation from the insurance side. I don't know where is my fault? I really want them to take the accountability for this.