Back in September, I needed to start getting infusion of a medication for a chronic disease. As part of the process, my doctor needed prio-auth to get the meds. The infusion center did all the work and informed me it went through. I have done 3 infusions, each is billed at 60K. Come last week, I get a message from insurance stating this treatment was not authorized. I frantically called both my drs office and the insurance and found that my doctors office submitted all the paper work only to receive a certified message back from the insurance company stating no prior-auth was needed. This message is dated, certified, and has an ID# which I have. I called the insurance and they said “uhhhh, we need to escalate this.” Because of the holidays, they aren’t open until Monday.
How can I go about forcing them to forgive these charges if they decide to put up a fuss about it? My treatment would have received authorization but the insurance company messed up. And if it didn’t receive authorization, I wouldn’t have gone forward with treatment. I just want to be ready when I talk with them on monday.
submitted by /u/invaderzimm95
[link] [comments]
Back in September, I needed to start getting infusion of a medication for a chronic disease. As part of the process, my doctor needed prio-auth to get the meds. The infusion center did all the work and informed me it went through. I have done 3 infusions, each is billed at 60K. Come last week, I get a message from insurance stating this treatment was not authorized. I frantically called both my drs office and the insurance and found that my doctors office submitted all the paper work only to receive a certified message back from the insurance company stating no prior-auth was needed. This message is dated, certified, and has an ID# which I have. I called the insurance and they said “uhhhh, we need to escalate this.” Because of the holidays, they aren’t open until Monday. How can I go about forcing them to forgive these charges if they decide to put up a fuss about it? My treatment would have received authorization but the insurance company messed up. And if it didn’t receive authorization, I wouldn’t have gone forward with treatment. I just want to be ready when I talk with them on monday.
submitted by /u/invaderzimm95 [link] [comments]Read Morer/HealthInsurance