by: Mark Becker Updated:
HUNTERSVILLE, N.C. - A woman who was knocked in the chin by her horse says she feels like she took it on the chin from her insurance company too, when she was told they would not pick up most of the cost of her emergency surgery.
"That's why I pay insurance," says April Battle. "(I pay) to have situations like this taken care of, an accident, and emergency."
She was trying to cut her horse out of some barbed wire at her farm in Huntersville early September when the horse hit her in the chin with its knee.
Her husband took her to the hospital in Huntersville where Dr. Raymond Haigney was called in to perform emergency surgery.
Dr. Haigney's bill came about $46,000, but Battle says the real shock came when the insurance company, Blue Cross and Blue Shield, informed her that since Dr. Haigney is not in their insurance network, they would only pay $2,000, leaving her with the other $44,000.
It was no surprise to Dr. Haigney, who says he has had problems getting reimbursements from Blue Cross over the last two years.
"It's not uncommon that it takes four or five months and I think our record is about 13 months later for getting reimbursement," Dr. Haigney says. Dr. Haigney took his past complaints all the way to the state's insurance commissioner, who has personally called the CEO of Blue Cross to intervene.
"I'm well aware of the concern and we have reviewed all of the claims and they have been attended to and paid," says Lew Borman, a spokesman for Blue Cross and Blue Shield of North Carolina.
Borman says he cannot comment on specific patients or cases, but North Carolina’s Insurance Commission says that April Battle’s insurance is actually with a Blue Cross and Blue Shield of Illinois, and they are the ones who have to decide how much she should be reimbursed.
Battle says she has contacted Blue Cross in Illinois but is still waiting and wondering whether she will get the check she needs to pay her bill.
"I don't know. I hope so," she says.
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