I’m trying to understand the heirachy of an insurance plan. If something is covered under the EOB, can it still be deemed medically unnecessary and denied after the appointment or procedure.
I’ve spent the entire morning trying to figure out whether or not an ultrasound will be covered. I was guaranteed by two different reps that ultrasound would be covered, however I’ve experienced problems in the past with things that are listed as covered later being denied due to being medically unnecessary. Is there anyway to actually find out the expenses before you do the procedure. It seems rather unethical to have to go into this without knowing the cost upfront. Any advice on how to approach this? Thank you
submitted by /u/janiexox
[link] [comments]I’m trying to understand the heirachy of an insurance plan. If something is covered under the EOB, can it still be deemed medically unnecessary and denied after the appointment or procedure. I’ve spent the entire morning trying to figure out whether or not an ultrasound will be covered. I was guaranteed by two different reps that ultrasound would be covered, however I’ve experienced problems in the past with things that are listed as covered later being denied due to being medically unnecessary. Is there anyway to actually find out the expenses before you do the procedure. It seems rather unethical to have to go into this without knowing the cost upfront. Any advice on how to approach this? Thank you submitted by /u/janiexox [link] [comments]Read Morer/HealthInsurance