So back in Sept 2021 I had a laprascopic surgery. Before surgery my husband called insurance with the codes we were given and they green lighted it all saying everything was covered after we hit our deductible. He asked numerous times if he needed to do anything else and if for sure it was all covered. The agent said yes. So, I had the surgery. A month later we get a $22k bill with insurance covering .5%. Insurance said that the actual building isn’t covered therefore it’s all out of network. We have been fighting insurance on it and they keep denying our appeals. We are on our last one. Is there any advice on what to specially say in our letters we have to write? The agent we have now been working with said almost all get denied still. So far I have written up a letter stating covid restrictions caused the surgery to be where it was (which are applicable), some medical history, and my doctor wrote a letter as well.
submitted by /u/ShoutingBunny
[link] [comments]So back in Sept 2021 I had a laprascopic surgery. Before surgery my husband called insurance with the codes we were given and they green lighted it all saying everything was covered after we hit our deductible. He asked numerous times if he needed to do anything else and if for sure it was all covered. The agent said yes. So, I had the surgery. A month later we get a $22k bill with insurance covering .5%. Insurance said that the actual building isn’t covered therefore it’s all out of network. We have been fighting insurance on it and they keep denying our appeals. We are on our last one. Is there any advice on what to specially say in our letters we have to write? The agent we have now been working with said almost all get denied still. So far I have written up a letter stating covid restrictions caused the surgery to be where it was (which are applicable), some medical history, and my doctor wrote a letter as well. submitted by /u/ShoutingBunny [link] [comments]Read Morer/HealthInsurance