Anything my father can do on this? He’s needed knee surgery for a while. His doctor I guess has some new surgery (rather than total knee replacement) that he wants to perform (that evidently has been a god send for everyone else that’s had it). It’s some sort of injection into the knee or something (sorry not sure of the exact name). But this has been scheduled twice now and each time, the day before my father gets a call saying it’s been cancelled because insurance decided they won’t cover it. So far the doctor has had a “peer to peer” on the topic with Medical Mutual where the doctor told my father that the “peer” he spoke with had never heard of this new surgery and that he had to decline for that reason (evidently the “peer” wasn’t even a doctor/surgeon but just some medical assistant). My father and his doctor has appealed it and Medical Mutual had 30 days to respond to the appeal and they’ve declined it again.
My argument is that he should maybe call the department of insurance and explain the situation? The fact that the doctor straight up said the “peer” he met with had no idea what the procedure was or would do just shows that they can’t make an educated decision on if my father needs it. My father can barely walk at this point and the damn doctor is saying “you need this” and the insurance says no way.
What’s his options?
submitted by /u/lexbuck
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Anything my father can do on this? He’s needed knee surgery for a while. His doctor I guess has some new surgery (rather than total knee replacement) that he wants to perform (that evidently has been a god send for everyone else that’s had it). It’s some sort of injection into the knee or something (sorry not sure of the exact name). But this has been scheduled twice now and each time, the day before my father gets a call saying it’s been cancelled because insurance decided they won’t cover it. So far the doctor has had a “peer to peer” on the topic with Medical Mutual where the doctor told my father that the “peer” he spoke with had never heard of this new surgery and that he had to decline for that reason (evidently the “peer” wasn’t even a doctor/surgeon but just some medical assistant). My father and his doctor has appealed it and Medical Mutual had 30 days to respond to the appeal and they’ve declined it again. My argument is that he should maybe call the department of insurance and explain the situation? The fact that the doctor straight up said the “peer” he met with had no idea what the procedure was or would do just shows that they can’t make an educated decision on if my father needs it. My father can barely walk at this point and the damn doctor is saying “you need this” and the insurance says no way. What’s his options?
submitted by /u/lexbuck [link] [comments]Read Morer/HealthInsurance