Insurance gave Dr wrong coverage info?!

[jenjackson 4]

Well, I got a voice mail on Friday that said there was definitely a mistake made by them and now they need some information to make an exception. This is good news! The bad news seems to be that she said she didn't see any pre-op claims. Not sure how that can be....I have done a sleep study, psych visits, surgeon visits, endoscopy and obtained a cpap machine. Hopefully she will answer my calls tomorrow. She did not answer at all Friday afternoon .

[1SlimmerMe 122]

Awesome news! They should rectify the mistake. Hang in there, you're much closer to the end!!!

[RyansGirl89 67]

Good luck and please let us know. I can't imagine the stress you must be under over this.

[belindadcns 55]

Keep us posted.Pray everything works out.

[newmebithebypass 713]

Keep us posted

[jenjackson 4]

I feel like I am in the middle of a nightmare! So, I finally got ahold of the lady who called me and we discussed the claims that were filed up to this point. She asked if I wanted those claims to be paid and I told her that I wanted the surgery covered that they told me was a covered benefit. She told me that she didn't think that would happen because the mistake was caught before the procedure. She put it to the claims exception committee and before the day was over I received a phone call back telling me that not only was the procedure not covered, but they were also not covering any of the copays or out of pocket costs from all of the pre-op work I had done. Even though I would have never had those medical expenses if I hadn't been pre-approved for the surgery, they didn't care. They said the claims were paid according to my coverage and I am stuck with hundreds of dollars of out of pocket costs.

I told her I wanted to know what to do next and she told me that I could appeal it so I am going through that route now and I have also contacted an insurance attorney to see what my options are.

I want to cry.

[Daisee68 2,493]

I am so sorry this is happening! You are on the right track with an appeal and an attorney. Good luck! Hang in there! Hugs!

[1SlimmerMe 122]

I wish I had something profound to tell you. The best thing I could say is hang in there. You are giving it the best fight you have, and that alone is commendable! I wish you the best!

[halalo 13]

I'm so sorry. Really it's getting complicated!! I'll pray for u. Keep us posted.