Hello Everyone!!! Wanted to get your take on something please. Back in May of this year, I had a fertility procedure performed by my urologist, who is an in-network provider with my health insurance company. Prior to the procedure, the medical provider called my insurance company to get preauthorization to move forward with the procedure (I have a $25k lifetime limit for fertility procedures through my heath insurance provider). My health insurance company stated erroneously that the procedure was not covered and I had to pay out of pocket for everything – $1840.00.
After the procedure and paying the cost out of pocket, I did some investigating and found out afterwards that the procedure should have been covered under my fertility benefits. After multiple phone calls, conferences and back and forth between my medical provider and insurance company, my health insurance company processed my claim a few days ago but would only pay out about $850. The EOB states that the original cost was $1840 but was decreased/written off almost $1000 due to being an in-network provider.
I know that the $850 is due back to me but am out of luck for that $1000 difference even though the insurance company was incorrect about my coverage prior to my procedure?
Just curious if I have any restitution here.
Thanks!!
submitted by /u/nyfan0101
[link] [comments]
Hello Everyone!!! Wanted to get your take on something please. Back in May of this year, I had a fertility procedure performed by my urologist, who is an in-network provider with my health insurance company. Prior to the procedure, the medical provider called my insurance company to get preauthorization to move forward with the procedure (I have a $25k lifetime limit for fertility procedures through my heath insurance provider). My health insurance company stated erroneously that the procedure was not covered and I had to pay out of pocket for everything – $1840.00. After the procedure and paying the cost out of pocket, I did some investigating and found out afterwards that the procedure should have been covered under my fertility benefits. After multiple phone calls, conferences and back and forth between my medical provider and insurance company, my health insurance company processed my claim a few days ago but would only pay out about $850. The EOB states that the original cost was $1840 but was decreased/written off almost $1000 due to being an in-network provider. I know that the $850 is due back to me but am out of luck for that $1000 difference even though the insurance company was incorrect about my coverage prior to my procedure? Just curious if I have any restitution here. Thanks!!
submitted by /u/nyfan0101 [link] [comments]Read Morer/HealthInsurance