insurance companies stink

maggielou
on 11/26/09 5:15 am
well let me give a brief overlook about my story...i start the whole procedure last year.  went thru the required diet, the nut eval everything.  the doctors office sent the paper work on 11/6/08.  found out that GOD gave me another little blessing that was due in July.  found out i was pregnant on 11/18/08 and recd appoval letter on 11/25.letter states approval good for12 months.  had a little girl in july. had surgery on  11/9/09.  hating pureed diet but doing good.  recd my hospital eob on 11/25 and they did not pay one penny of the surgery.  insurance company says that i was past the 12mon period and so it is not covered.  after arguing with them they are going to submitted again.  i get tired of fghting every little thing with the insurance company.  my argument is that no where on the letter states that the date to go by is the submitted but not the letter date.  and why would they do the preadmission approval and the approval for the hospital stay if it was not going to be covered.  they said it exired on 11/7 two days before my surgery. myself and the doctors office was in contact with the insurance company 3 days before surgery date no one bothered to us then?  does this make any sense?????
sorry to vent but this is crazy
        
k9ophile
on 11/26/09 12:13 pm

No sense at all.  It seems to me that the year would be from the date they notified you that you were approved or at least the date they made the decision to approve.  The expiration date should have been clearly stated in the letter such "This approval expires on xx-xx-200x."  That's what makes sense, so that's why they aren't using that date.  They will do anything to keep from paying.  Keep after them. 

In the meantime, just love on that precious baby girl.  Holding her has to be good medicine.

"Our ultimate freedom is the right and power to decide how anybody or anything outside ourselves will affect us."  Stephen Covey

Don't litter!  Spay or neuter your pet

maggielou
on 11/28/09 10:18 am
that was my exact agrument with the insurance company...why  would they approve the hospital stay  and everything else for the surgery on 11/9 just to deny it. i am grateful that the agrument is after the surgery and not before.....i guess if they decide not to pay i will just have a huge bill that  will take forever to pay
Most Active
Recent Topics
×