Question:
has anyone had their insurance deney after pre-dtermination approval?

I have CIGNA PPO insurance - before surgery I went through all of their requirments and got a letter in writing saying that they approve of the proceedure. In this letter CIGNA even outlined by deductibles, co-pay, etc. Now that the bills are coming in they are paying very weird or not paying at all. The bill for the anethesiologist was paid in full but the surgeon who did my surgery is not going to be paid until they get a letter of medical necessity. I just don't get it. Oh and the Hospital portion of the bill they are not going to pay until they get an itemized bill, so they say, well I got a copy of the bill and it looked itemized to me (i.e. dates, codes, etc.). Has anyone elese experienced this and if they denied you after the fact, how did you handle it. I am getting very nervouse. Thank you.    — blank first name B. (posted on January 13, 2002)

January 13, 2002
I would call and talk to a supervisor especially about the surgeon needing to supply a letter of medical necessity since you had had already been approved if this doesn't work if your state has an insurance board I would report it to them or I would call the attorney generals office you may want to mention that to the supervisor. Good Luck!
   — Candace F.