Approved but still insurance issue
on 11/22/06 12:44 pm
you may be able to apeal but did you find out the amount of balance billing you would be responsible for? Every company and every policy is different but as long as you are in network regardless of the cap you should be billed the contracted rate which can be as little as an 1/8 of the cost of the billed services or more you may be able to apeal but chances are if you have a 7500 cap that anthem is just doing the administrative end of you health insurance for your employer which means that its not up to them they proccess the claims and charge administrative fee's but your employer is the one who pays the claims and chooses what is and is not covered as well as the amount of any cap that is assigned to a benefit if that is the case then i would try an apeal because some companies aprove almost all apeals and some hardly aprove any so you have a 50/50 chance.... well i hope i made sense and could be of some help.... Good luck :) and if all else fails 7500 should be enough for you to get the lap band.