Long story short, I’ve been seeing a psychiatrist in NC for a year with BCBS. My place of employment recently stopped offering BCBS and I was forced to choose United Healthcare. I signed up Oct. 2020, picked a primary care physician which is ‘required’ with this plan. I didn’t I notice until now that they didn’t use the PCP I chose but randomly selected one for me. Therefore my last two visits to the psych(Jan & Feb) were not covered due to me not having a referral from the PCP that they chose for me. I had a referral to my psychiatrist from my Obgyn last year so I figured I wouldn’t have to get ANOTHER referral from another doc(the one they chose for me). I spoke to United Healthcare and they said there’s nothing they can do unless I want to file an appeal. I changed my PCP but it won’t take effect until March. I understand I should have caught the mistake of the wrong PCP being selected in the beginning but I was a month and a half too late. Do I have any chance of winning an appeal for the last two denied claims that total close to $2,000? If so, what kind of stuff should I write in the appeal. I’m completely clueless 🙁
submitted by /u/djean271
[link] [comments]
Long story short, I’ve been seeing a psychiatrist in NC for a year with BCBS. My place of employment recently stopped offering BCBS and I was forced to choose United Healthcare. I signed up Oct. 2020, picked a primary care physician which is ‘required’ with this plan. I didn’t I notice until now that they didn’t use the PCP I chose but randomly selected one for me. Therefore my last two visits to the psych(Jan & Feb) were not covered due to me not having a referral from the PCP that they chose for me. I had a referral to my psychiatrist from my Obgyn last year so I figured I wouldn’t have to get ANOTHER referral from another doc(the one they chose for me). I spoke to United Healthcare and they said there’s nothing they can do unless I want to file an appeal. I changed my PCP but it won’t take effect until March. I understand I should have caught the mistake of the wrong PCP being selected in the beginning but I was a month and a half too late. Do I have any chance of winning an appeal for the last two denied claims that total close to $2,000? If so, what kind of stuff should I write in the appeal. I’m completely clueless 🙁
submitted by /u/djean271 [link] [comments]Read Morer/HealthInsurance