insurance denied AFTER approval and surgery

D S.
on 10/23/04 11:02 am - PA
I had my surgery approved and done on 8-10-04. Now the insurance company is saying they will not pay for the doctor. The reason is, they approved a short limb surgery and my doctor felt that a long limb surgery was best for me. He charges the same ammount but because it was the long limb, they refuse to pay him. They say the long limb surgery is just experimental. Did anyone else encounter this problem? What was done?
Roberta A.
on 10/24/04 3:01 am - Marietta, GA
I would discuss this with your surgeon. Did s/he submit a prior approval request to the insurance company for the short limb, and then decided to change his mind once he was in surgery? Did the surgeon discuss the change of procedure with you PRIOR to the operation? Please check into the particulars, and get back to us for a follow up strategy. Fight the good fight! Roberta
Laura R.
on 10/27/04 9:53 am - scottsdale, AZ
email [email protected] or go to his website. He helped me. Good luck. L
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