Tl;dr at the bottom
My family member will be getting surgery. The specific surgery requires a specialist. The only in network specialist is 80 minutes away in a different county. This is the provider the insurance initially referred us to. But there is another specialist only 30 minutes away in our county.
I fought with the insurance and after much back and forth, they agreed that the out of network provider should be assigned to do the surgery since they’re the only specialist in the county and the in network provider is too far.
So we got the pre-authorization for the out of network provider.
Can I trust the insurance to cover the surgery? We have the preauthorization and reference numbers for the phone calls with the insurance, but the fact that it’s with an out of network provider frightens me. I wouldnt put it past them to try to pull a fast one and deny the claim even though they authorized it.
Tl;dr, Insurance approved preauthorization for a surgery by an out of network provider because they’re the only specialists in the area. Can I trust insurance will cover the surgery?
What are the questions I can ask and steps to take on my end to ensure we dont get a bs bill for this?
Thank you guys!
submitted by /u/usernamesarehard223
[link] [comments]Tl;dr at the bottom My family member will be getting surgery. The specific surgery requires a specialist. The only in network specialist is 80 minutes away in a different county. This is the provider the insurance initially referred us to. But there is another specialist only 30 minutes away in our county. I fought with the insurance and after much back and forth, they agreed that the out of network provider should be assigned to do the surgery since they’re the only specialist in the county and the in network provider is too far. So we got the pre-authorization for the out of network provider. Can I trust the insurance to cover the surgery? We have the preauthorization and reference numbers for the phone calls with the insurance, but the fact that it’s with an out of network provider frightens me. I wouldnt put it past them to try to pull a fast one and deny the claim even though they authorized it. Tl;dr, Insurance approved preauthorization for a surgery by an out of network provider because they’re the only specialists in the area. Can I trust insurance will cover the surgery? What are the questions I can ask and steps to take on my end to ensure we dont get a bs bill for this? Thank you guys! submitted by /u/usernamesarehard223 [link] [comments]Read Morer/HealthInsurance