Insurance Company

Well everyone I called my insurance company this morning. The women I talked to wasn't the nicest person in the world. She told me it was a pre-determination, I had to have the doctor submit the paper work and they would make a decision. I guess it depends on the situation. Has anyone ever ran into this?

Wendy, I knew before I even read your profile that Medical Mutual was your insurance carrier. I also have them and they are the worst insurance company to deal with. And they are also very rude. I have been fighting with them for over a year trying to get approved for surgery. So now I have an attorney that is doing my appeal for me. My husband is now wanting to have the surgery so he called a phyc. doctor to get his review done and the doctor asked what was his insurance company he said Medical Mutual and the doctor told him they were the worst to deal with. Just hang in there and don't give up dealing with Medical Mutual. Good Luck! Michelle

Wendy, NEVER, NEVER, NEVER accept "It depends on the situation". That's BS that's just said to stall you out. I was told "You don't have that coverage" but I knew I did because a man at my job had the same procedure done just weeks before me. Keep in mind this is in most cases without complications a $25,000+ procedure and they are usually not in to big of a hurry to just hand out that much money for one procedure that they don't consider "life threatning". In my experience with insurance companies, they will not just tell you on the phone, they make you jump thru the hoops first. Good Luck and don't give up Temeka