General insurance question

AngelaRevised
on 8/1/16 9:47 am - Framingham, MA
Revision on 08/21/16

My insurance recently denied my surgery. I only know this because I can see the status online, as can my surgeons office. I called the insurance and they claim that they don't have access to WHY I was denied and that we have to wait for the letter- which is being sent to the surgeon and not me. Is this common? Confused why I wouldn't get a denial letter directly as well.. And I swear I've read about people speaking directly to their insurance and were able to find out why they were being denied- am I wrong? 

 

Just frustrated! Thanks for "listening!" 

Kudzu
on 8/1/16 10:50 am
VSG on 07/28/16

I see you're trying to be approved for a revision, could that be why, if they paid for one surgery for you already? Or maybe you'll just need to meet more of their guidelines that'll hopefully be included in the letter they send out. Good luck. I hope you get your approval eventually. 

AngelaRevised
on 8/1/16 10:55 am - Framingham, MA
Revision on 08/21/16

Thanks for your reply. They didn't pay for my first surgery, but my policy doesn't have a one surgery rule anyway, especially for surgical complications. And I do meet all of their requirements for a revision, I'm sure of that...

My question is just HOW do I find out why I was denied if they won't tell me and is it common practice for only the surgeon to get a letter. I see all the time here that people get denial letters, in hand.

Kudzu
on 8/1/16 11:35 am
VSG on 07/28/16

Insurances; gotta love 'em or hate 'em. Ask them to put you in contact with someone who DOES know what's going on with your denied status case? I wish I knew the answer. Fortunately, I've not had that problem with mine. I hope you reach someone who can explain what's going on. 

AngelaRevised
on 8/1/16 11:44 am - Framingham, MA
Revision on 08/21/16

Thank you.. I feel like they are being difficult just for the sake of being difficult. Surgeons office seems to think they want a different code. Hopefully it's that simple! 

Valerie G.
on 8/2/16 4:48 am - Northwest Mountains, GA

I would call a few times and try different people.  Some may be more apt to disclose information, or go through the hoops to look it up than others.

Valerie
DS 2005

There is room on this earth for all of God's creatures..
next to the mashed potatoes

Sparklekitty, Science-Loving Derby Hag
on 8/1/16 11:44 am
RNY on 08/05/19

Every insurance company operates differently. Some will provide more info, others will only talk to your doctor.

I'd suggest waiting until your surgeon receives a letter, then ask if they can forward a copy along to you.

Sparklekitty / Julie / Nerdy Little Secret (#42)
Roller derby - cycling - triathlon
VSG 2013, RNY conversion 2019 due to GERD. Trendweight here!

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