How long does Insurance have to approve or deny you?

brandonbrooke
on 7/16/07 7:47 am
I am in Wisconsin I have title 19 badgercare for insurance. I was told by law they have 20 days to approve or deny coverage for surgery. My 20th working day was up last Wednesday, but when I call they say its still pending. I asked about the 20 days and all they can tell me is, well I really don't know. Does anyone know forsure?
(deactivated member)
on 7/17/07 12:20 pm - TX
It would depend on the contract, i am guessing... my insurance carrier states that they have 30 days.
wendy_fou
on 7/18/07 1:57 pm - AR
My insurance has 15 days. 
.::Princess
Nutmeg::.

on 7/22/07 10:22 am - Rohnert Park, CA
In California it's 30 days; they must approve or deny. Then they have 30 days to approve or deny the appeal. That's when it gets interesting. If they go more than 30 days, then you get to call DMHC (the big scary government that will make the HMO behave). I am not a lawyer, this is just what I've learned so far. :D
(Hi/DoS/CW/GW) 335/320/243.5/174  (-91.5)(total lost) in 18-20 dependent on brand!
I'm more than half-way there! :) (68.5 pounds to go)
j0nesy22
on 7/26/07 3:44 am
It depends on what type of plan you have also.. it its self funded or fully insured.  Some plans do NOT have to follow state regulations because they are not funded at all.  Insurance is so tricky so while you think by state law you have X amount of days, it may be true but not with YOUR particular plan.  I would check into it and see what exactly you have.
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