I got stuck with a very large bill because my insurance through my employer said that they covered telehealth… but then denied the claim because my specific diagnosis wasn’t covered for telehealth. After being on the phone long enough with my insurance trying to figure out why my five monthly appointments weren’t being covered, they told me that an ADHD diagnosis wouldn’t be covered for telehealth, but if it was coded under something else (she said, specifically, like anxiety, after saying she couldn’t tell me what is/isn’t covered because of insurance fraud reasons), then it would be covered.
My doctor/provider is almost as frustrated as I am with this. If my plan benefits say that telehealth is “covered, same benefit”, is there a reason why it would only apply to a specific diagnosis? Do I have any room to argue with my insurance that they had told the provider that telehealth was covered, and then backtracked once they saw the diagnosis code? All of my plan benefits information lump behavioral and mental health in one category. Where could I find the information that breaks it down by diagnosis if it’s not in my plan benefits pamphlets/booklets?
submitted by /u/money_maiden
[link] [comments]I got stuck with a very large bill because my insurance through my employer said that they covered telehealth… but then denied the claim because my specific diagnosis wasn’t covered for telehealth. After being on the phone long enough with my insurance trying to figure out why my five monthly appointments weren’t being covered, they told me that an ADHD diagnosis wouldn’t be covered for telehealth, but if it was coded under something else (she said, specifically, like anxiety, after saying she couldn’t tell me what is/isn’t covered because of insurance fraud reasons), then it would be covered. My doctor/provider is almost as frustrated as I am with this. If my plan benefits say that telehealth is “covered, same benefit”, is there a reason why it would only apply to a specific diagnosis? Do I have any room to argue with my insurance that they had told the provider that telehealth was covered, and then backtracked once they saw the diagnosis code? All of my plan benefits information lump behavioral and mental health in one category. Where could I find the information that breaks it down by diagnosis if it’s not in my plan benefits pamphlets/booklets? submitted by /u/money_maiden [link] [comments]Read Morer/HealthInsurance