Question:
Ins denied verbally and refuses to send me letter denying

They won't even give me a benefit booklet. I have Highmark BCBS. Any suggestions or letters I can use when they deny verbally?    — Samathal8585 (posted on March 26, 2008)

March 26, 2008
Is it your insurance or are you the dependent of another? If it's your insurance, I think by law they have to provide you with a benefit booklet. If you are a dependent of someone else's policy, then they may have to request it.
   — Dave Chambers

March 26, 2008
First, the policy holder has to call them or the insured. If you are a spouse of the insured, then have your spouse call them. They have to give you a policy booklet, and they have to allow you to appeal the denial. Start by having your doctor check on your coverage. If you have not selected a sergeon, do so and ask them to do the requist for coverage. tehn they will send him and you or the policy holder a letter as to the reason. The doctor will know if you have to prove other issues to have the surgery, like High Blood Pressure, dieabities, etc. The only way they can denial all coverage if there is a statement that says "No Baratric coverage will be allowed regardless of the patients issues" Then you can got to www.obesitylaw.com and ask them to assist you.
   — William (Bill) wmil

March 26, 2008
I have Highmark BC/BS. Get your insurance card, go to www.highmarkbcbs.com, go to "manage your plan" sign up with your ID and Group number; you can view your entire Benefit Booklet or print it out.
   — MiniMello

March 26, 2008
I also have this insurance and they sent me a letter and my doctor's office took care of it from there. best of luck
   — Alvernlaw

March 26, 2008
Every state has a gov't department that regulates Ins. Call the Ins let them know you will contact the reg. agency. That is usually all it takes. If not, file a complaint they have 30 days to make it right.
   — Donna O.

March 28, 2008
The best place to go is to your doctor's billing employee. They definitely know why your insurance denied you. Also, consider using a self-pay process with financing.
   — jennycad