I’m beyond frustrated. Anytime I leave the state for services I apparently have to have prior approval. I tried to stay in state for a surgery and was referred out of state by the physician. The new out of state physician wanted to me to get a mammogram as part of my preop which then turned into an ultrasound and then breast biopsy. I told the ordering physicians office that I would need pre authorization due to it being out of state and the lady fought me on it twice, insisting that I didn’t need it. I got frustrated with her and reached out to the doctor herself who then submitted the request. A week and a half later I went to the biopsy appointment assuming it was fine. I got a letter a week later saying I was denied because it was out of state. I’m worried sick that I’m going to have a huge bill. It has been a huge pain dealing with all of the out of state appointments and my insurance. I plan on appealing, but have no idea how to go about that. This is so frustrating. I even asked the ordering doctor if I could have these appointments done closer to home (in state) but she wanted it done at their hospital. I’ve been trying my best to stay on top of insurance and then this happens. Any chance I could appeal? I’ve already reached out to the ordering physicians office, but waiting to hear back.
submitted by /u/DunderScott5678
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I’m beyond frustrated. Anytime I leave the state for services I apparently have to have prior approval. I tried to stay in state for a surgery and was referred out of state by the physician. The new out of state physician wanted to me to get a mammogram as part of my preop which then turned into an ultrasound and then breast biopsy. I told the ordering physicians office that I would need pre authorization due to it being out of state and the lady fought me on it twice, insisting that I didn’t need it. I got frustrated with her and reached out to the doctor herself who then submitted the request. A week and a half later I went to the biopsy appointment assuming it was fine. I got a letter a week later saying I was denied because it was out of state. I’m worried sick that I’m going to have a huge bill. It has been a huge pain dealing with all of the out of state appointments and my insurance. I plan on appealing, but have no idea how to go about that. This is so frustrating. I even asked the ordering doctor if I could have these appointments done closer to home (in state) but she wanted it done at their hospital. I’ve been trying my best to stay on top of insurance and then this happens. Any chance I could appeal? I’ve already reached out to the ordering physicians office, but waiting to hear back.
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