Anyone with experience on fighting insurance claim?

Question

I phoned and asked my insurance if something was covered and was told yes, but now my claim has been denied and o am left with a $5000 bill. Anyone with any experience in overturning insurance claims? I feel like because I was told it would be covered 100% they are at fault.

Answer

A procedure may be covered by your insurance, but if you have a deductible or copay, you still have to pay that first. Being covered just means the procedure is included in your policy, but you always have to pay the deductible and copay regardless if it's covered or not.

Answer

Are you the one that posted about the genetic testing yesterday? 
Your best bet is to contact your insurance and figure out what’s going on. It could have been accidentally billed under the wrong code so it wouldn’t be approved even though it should have or it could have been the persons mistake who told you it was covered but it actually isn’t. You may also just be paying your copay. Maybe your insurance covers whatever it is in certain circumstances but yours don’t meet them.

Answer

Do you have the conversation number from when you spoke with them? Send them a letter and send a copy to your state department of insurance too. I got one overturned in NJ that way.

Answer

I have filed an official formal appeal with our insurance company. They told both my husband and the urologist that his vasectomy would be partially covered and after it was done we got the whole bill. The biller at the urologist office called back and they denied talking to her and giving her that quote, the same quote they gave my husband (which they also mysteriously dont have records of). We filed the appeal and now we wait. It can take up to 90 days to get a resolution.

Anyone with experience on fighting insurance claim?

Let's Glow!

The Top Baby Tracker App: Embrace New Beginnings with Tender Care

The Top Fertility Tracker App: Your Path to Achieving Pregnancy

The Top Pregnancy App: Nurturing Your Journey to Motherhood

The Top Period Tracker for Empowering Your Menstrual Health Journey