From what I understand, Insurance companies use the vagueness of the literature to justify not paying. They also will create arbitrary standards for approving a procedure and will retrospectively review cases and decide that since a report wasn’t phrased perfectly they will not pay. The patient will have to take the case to a lawyer if/when they deny it again.
I have heard of patients having the pre-approvable from the insurance companies for a procedure only to have the bill turned down after the fact.
I do not have an answer but I am thankful that so far our health insurance has cover the many procedures and surgeries my husband has had over the years. His last surgery in 2010 cost over $100,000.00 and having to cover about $ 6,000.00 was a strain for us.
I truly understand peoples fears and frustrations re health insurance.
~~Kitt~~Moderator: Anxiety, Osteoarthritis,
GERD/Heartburn and Heart/Cardiovascular Disease. "I am not afraid of storms for I am learning how to sail my ship" ~ Louisa May Alcott