Insurance Denial After Surgery

[ANKPTA 0]

Has anyone had trouble with their insurance not wanting to cover your surgery after you have had it done? I got a call from the Hospital today on my answering machine that they were having trouble with my insurance company and to call them. I also received a letter a month or so ago from the insurance company saying that I am responsible for $21,000 and that they are responsible for $0. If anyone has has this problem how was it resolved? Thanks for any info.

[MacMadame 81]

Do you have your original approval letter with your approval code? If so, you should call them and remind them of it.

[sonipez 0]

OMG! :laugh: Is that even legal?! What finally happened?

[ANKPTA 0]

sonipez, I have two insurances mine & hubby's...I had asked the receptionist at the weight loss center (when I started) if she needed both insurance cards (because we knew that mine doesn't cover the surgery at all) and she said no. Well the business office at the hospital said that since mine is primary we needed to submit to them first and get a refusal (even though we already knew that it doesn't cover) and then submit to my husbands. That didn't happen because they didn't take the info from mine to begin with (their fault because I asked if they needed it.) Anyway, the lady at the business office said that they were going to try and submit it all again...sending my insurance through first. I actually got an email the other day that my insurance paid $6000 of it...haven't heard anything else. I am taking no news as good news...