"AmyRose" 2 Posted June 9, 2011 I am now just waiting for approval form the insurance. I have done all that they ask and require but I am still worried that I will be denied coverage. Has anyone ever been denied even though it is a covered procedure? Share this post Link to post Share on other sites
Wheetsin 714 Posted June 9, 2011 Denials aren't typical assuming a few things: * You don't have an employer-enforced exclusion. Did you check on this? Just because [insurance company] doesn't exclude something, does not mean it is covered in your plan. * You meet the plan's medical requirements for the surgery. * You don't mee tthe plan's qualifications for denial (a concern more in future years than right now). WIth those conditions met, you should (not will, but should) be approved. If you are not, you need to find out the specific reason for your denial and appeal it. Insurance companies follow guidelines. They cannot arbitrarily deny procedures. Their rationale may not make sense to you, but there does have to be some rationale there. (Used to work for an insurance company) Share this post Link to post Share on other sites
MassMom01527 26 Posted June 9, 2011 Definitely check your insurance plan's requirement for coverage of the procedure. I went through this just last week. I was sooo nervous even though I met the requirements (according the benefit hankbook). I was paranoid that the authorization wouldn't come though. The suspense got the better of me in the and I called my provider directly and asked if it had been approved. I couldn't wait to get the call back from the surgeon. They told me that it had been authorized. Woohoo! Just call your provider and ask directly Share this post Link to post Share on other sites
Grider 92 Posted June 9, 2011 They shouldn't stress us out like this- for real. Share this post Link to post Share on other sites