What do I do

tawandabee · May 25, 2009

I am so:cursing: mad my insurance company called to tell me my claim was denied for the surgery because the doc did not get the approval, and they want me to file a grievance against the him. But i need some help I have to get a fill on friday the 29th and the doc office havent called me yet.. :lol:

Want2BeThin · May 25, 2009

What insurance do you have? I work in billing for the hospital here where I live. I can tell that you that the member cannot be held responsible for the bill when the dr did not prior approval.

If your insurance did not approve your surgery then they are not going to pay for the fill either as it is related.

The insurance company is correct, you have to file a grievance. Were you not aware the surgery wasn't approved?

tawandabee · May 26, 2009

No I did not know that it was not approved. The assistant explained that it will be canceled if they did not get auth before surgery date. After they did not cancel I thought all well good:mad: