So, I had a double mastectomy (I am a male, and it was deemed medically necessary by physician). It was pre authorized and I thought all was good. I paid my remaining deductible to the surgeon, anesthesiologist, and labs which adds up to $9k and some change. But then today, six months after a successful surgery, I received in the mail a letter from insurance (Anthem) showing that the claim for the hospital (two charges of something $9k each and change [both charges exactly the same so there might be an error there too]) was denied and the appeal on the part of the hospital was denied because the procedure was deemed not medically necessary. I have NOT received a bill from hospital though. If I go to Anthem claims page, it says that all the other bills are approved as they should but on this hospital bill, it says denied but happens to show the full amount as “Plan discounts” also and says “responsibility – $0”. What should I expect from this? Will I be receiving a bill from the hospital? The surgeon’s office already got this approved ahead of time and it was deemed medically necessary before. Idk what to think.
submitted by /u/allexkramer432
[link] [comments]So, I had a double mastectomy (I am a male, and it was deemed medically necessary by physician). It was pre authorized and I thought all was good. I paid my remaining deductible to the surgeon, anesthesiologist, and labs which adds up to $9k and some change. But then today, six months after a successful surgery, I received in the mail a letter from insurance (Anthem) showing that the claim for the hospital (two charges of something $9k each and change [both charges exactly the same so there might be an error there too]) was denied and the appeal on the part of the hospital was denied because the procedure was deemed not medically necessary. I have NOT received a bill from hospital though. If I go to Anthem claims page, it says that all the other bills are approved as they should but on this hospital bill, it says denied but happens to show the full amount as “Plan discounts” also and says “responsibility – $0”. What should I expect from this? Will I be receiving a bill from the hospital? The surgeon’s office already got this approved ahead of time and it was deemed medically necessary before. Idk what to think. submitted by /u/allexkramer432 [link] [comments]Read Morer/HealthInsurance