I was referred to an MRI by my doctor’s office and told that the hospital would take care of the pre-authorization, then once they had it, call me to schedule the appointment. UnitedHealthcare confirmed this was the chain of events, too, when I called to ask more questions. The hospital called about a week later, confirmed they had the pre-auth, then scheduled the appointment.
I had that MRI on 7/13. I received a letter in the mail today from Evicore that said the MRI was approved but had the listed dates for authorization between 7/13 – 8/28 and had a specific hospital it appeared they wanted me to go to for that authorization. I did not go to that hospital on 7/13 but another one in the same network of CenturaHealth hospitals 25 miles closer to my home that the hospital called and told me to go to when they said I had the pre-authorization to make the MRI appointment.
Is this going to bite me in the butt when the claim is submitted? What should I look out for/be prepared for? The hospital had me pay my entire deductible and co-insurance at the type of service.
I just want to know if I need to gear up for a fight and/or what I should do in the future to avoid issues like this since neither UnitedHealthcare told me I needed to wait for this letter from Evicore when I called to ask how it would work, nor did the hospital or my doctor.
Any insight and/or help would be much appreciate. Thank you!
submitted by /u/iceicewhiskey
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I was referred to an MRI by my doctor’s office and told that the hospital would take care of the pre-authorization, then once they had it, call me to schedule the appointment. UnitedHealthcare confirmed this was the chain of events, too, when I called to ask more questions. The hospital called about a week later, confirmed they had the pre-auth, then scheduled the appointment. I had that MRI on 7/13. I received a letter in the mail today from Evicore that said the MRI was approved but had the listed dates for authorization between 7/13 – 8/28 and had a specific hospital it appeared they wanted me to go to for that authorization. I did not go to that hospital on 7/13 but another one in the same network of CenturaHealth hospitals 25 miles closer to my home that the hospital called and told me to go to when they said I had the pre-authorization to make the MRI appointment. Is this going to bite me in the butt when the claim is submitted? What should I look out for/be prepared for? The hospital had me pay my entire deductible and co-insurance at the type of service. I just want to know if I need to gear up for a fight and/or what I should do in the future to avoid issues like this since neither UnitedHealthcare told me I needed to wait for this letter from Evicore when I called to ask how it would work, nor did the hospital or my doctor. Any insight and/or help would be much appreciate. Thank you!
submitted by /u/iceicewhiskey [link] [comments]Read Morer/HealthInsurance