Obamacare Fleeced Me. What Do I Do?

Yeah this is classic stuff here in America. It stems from two problems

1. Americans have a different idea of what medical care should be like than the rest of the world. We want more, not necessarily better. Its because we have to pay so god damn f***ing much for our care, that when we go to the doctor for any mild pain, we want to see multiple doctors and then get x rays. Then a prescription even if all the above yields jack s***

2. The hospitals, knowing that people usually want all this s***, do it anyway, often without asking if you want the whole smorgasbord of consultations. Each one of those doctors probably charged separately, completely ignorant to whether or not you had insurance or if that doctor was even covered by your plan. there have been noted cases where out of plan doctors are used for consultations while a patient is unconscious and the patient is still billed

As a vaguely related antidote, my girlfriend got really f***ed over by her insurance company recently. She had to get double jaw surgery because her jaw was growing apart to the point where if not remedied, her jaw would have split in half at some point. Was deemed 100% necessary by her doctor and surgeon. Takes this to the insurance company (Cigna) and they say itll be covered. She gets the surgery, then some weeks later she gets the bill for over 15k. She calls her insurance company relatively calmly because it seems like a simple error. There started a 2 month long battle where they put her on hold for hours at several points, just to ultimately tell her that they made a clerical error when they said it was going to be covered and that they shouldn't have told her that. So it wasnt covered because despite being deemed necessary by the doctors, the insurance called it voluntary. Then they proceeded to flatout ignore letters sent by her surgeon, pleading them to change their mind because it wasnt an optional procedure at all. Just ignored. Never got back to her. Ended up having to dump out all her savings plus some at age 21 because of this

I don't understand why the insurance company won't cover the costs; because they believe the stay was unnecessary? 

But then the hospital nurses and doctors are telling you that it is necessary for you to stay, so they will not let you leave?

So either the hospital is claiming a fraudulent diagnosis to make you stay and rack up the bill , or your insurance is claiming fraudulent reasons for not having to pay the hospital.

Definitely get a lawyer. What is your insurance company, out of curiosity?

Did you file a case with your insurance company? They will pretty much handle the entire investigation. FYI you have a right to all of your PHI (health info), both from the insurance company and from the hospital. There's some red tape around procedures as far as anything administrative is concerned though.

Also if your hospital does decide to ask you about your bill, you should be prepared to refer them to the investigation (and the individuals under investigation).

Fyi I'm no expert on these things, I'm just giving an overview of what any employee is supposed to know on these things. You shouldn't consider me a legal expert, and I'm not speaking on behalf of any company here. I do know that these companies basically exist to fight fraud so they should help, regardless of what company it is.