Missouri Law, Insurance Company and Psych Exam

Hi, Just wanted to pass along something I found out. My insurance company has been a real pain in the a$$ and I have had to fight them on absolutely everything on this surgery. When I first started trying to get this done in October, the surgeon set me up for all the specialist visits, and they called and told them they would not cover anything until the surgery was precertified. Then, in December, they called and told me they couldn't cover because I didn't have the psych visit and a couple of other things. I told them that I did not have it because they had said I couldn't get it until they decided to cover, and now they were saying they wouldn't cover until I got it! I told the rep that I could get that done quickly, but wanted to be sure it would be covered. The rep told me that yes, it would be covered, so I went and had it done. Of course, they then refused to cover it after the fact. I had checked their website for mental health providers and there were none in my area listed, so I went to the one the surgeon said to use, and the company said they were out of network, so no coverage. I ran across a Missouri law, Regulation 20 CSR 400-2.160 that states that the company must provide two visits annually for "diagnosis or assessment of mental health", and it stipulates that they cannot limit the choice of provider. I sent this to the company, and they are finally going to cover this as they should. I just wanted to share that in case it helps out anyone else. Thanks!

Very good info. Thanks for sharing. Tara