I’ve had my current plan since August (Aetna in NJ), this is the second time this has happened. The first time I had to fight for months to get approval for an MRI and they could not offer an alternative treatment that they deemed preferable.
I had a routine ultrasound for a pregnancy a few weeks ago, and the claim was partially denied, again because it wasn’t deemed medically necessary. I had lab work done, also routine for pregnancy. The explanation was that since the labs were done there was no need for a doctor to review the ultrasound. These are routine tests that are done for all pregnancies and I’m not sure how they’re deeming it medically unnecessary treatment. I’m not even sure where to go from here. It looks like the hospital plans to balance bill me which I’m certain isn’t even legal. How in the world do you fight these I can’t file complaints with the state every single time they do this, but I don’t see what else can be done. They’re basically saying that they know better than my doctor about what treatment I need.
Any advice for how to combat this without filing complaints with the state? Thank you
submitted by /u/janiexox
[link] [comments]I’ve had my current plan since August (Aetna in NJ), this is the second time this has happened. The first time I had to fight for months to get approval for an MRI and they could not offer an alternative treatment that they deemed preferable. I had a routine ultrasound for a pregnancy a few weeks ago, and the claim was partially denied, again because it wasn’t deemed medically necessary. I had lab work done, also routine for pregnancy. The explanation was that since the labs were done there was no need for a doctor to review the ultrasound. These are routine tests that are done for all pregnancies and I’m not sure how they’re deeming it medically unnecessary treatment. I’m not even sure where to go from here. It looks like the hospital plans to balance bill me which I’m certain isn’t even legal. How in the world do you fight these I can’t file complaints with the state every single time they do this, but I don’t see what else can be done. They’re basically saying that they know better than my doctor about what treatment I need. Any advice for how to combat this without filing complaints with the state? Thank you submitted by /u/janiexox [link] [comments]Read Morer/HealthInsurance