My daughter had a procedure done several weeks ago. Before the procedure, I got a letter from our insurance saying they couldn’t cover it unless the doctor sent them a letter explaining why it was necessary. I called the dentist office ahead of time and explained this to them and said I wanted to make sure it was taken care of. It is not a procedure we absolutely had to get done, though my daughter really wanted it done, but it was $30 co-payment versus $750 out of pocket.
Day of the procedure I arrive and ask about it again, explaining to her the letter I received from insurance a week or two before and wanting to make sure I got approval, how I am not comfortable paying$750 for this procedure if insurance won’t cover it. The secretary says “No, the doctor must have sent the letter. You only owe $30.” I paid the $30.
Fast forward to today I get a letter from the insurance saying they are closing the case and rejecting it because they never got the letter.
I am hoping the dentist can resubmit with the letter and get this all taken care of, but if that somehow doesn’t happen, do I have any ground to stand on to not paying the$750? I feel like I did everything I could have on my end to have made sure the procedure was covered before my daughter got it done.
submitted by /u/MembershipIll8061
[link] [comments]My daughter had a procedure done several weeks ago. Before the procedure, I got a letter from our insurance saying they couldn’t cover it unless the doctor sent them a letter explaining why it was necessary. I called the dentist office ahead of time and explained this to them and said I wanted to make sure it was taken care of. It is not a procedure we absolutely had to get done, though my daughter really wanted it done, but it was $30 co-payment versus $750 out of pocket. Day of the procedure I arrive and ask about it again, explaining to her the letter I received from insurance a week or two before and wanting to make sure I got approval, how I am not comfortable paying$750 for this procedure if insurance won’t cover it. The secretary says “No, the doctor must have sent the letter. You only owe $30.” I paid the $30. Fast forward to today I get a letter from the insurance saying they are closing the case and rejecting it because they never got the letter. I am hoping the dentist can resubmit with the letter and get this all taken care of, but if that somehow doesn’t happen, do I have any ground to stand on to not paying the$750? I feel like I did everything I could have on my end to have made sure the procedure was covered before my daughter got it done. submitted by /u/MembershipIll8061 [link] [comments]Read Morer/HealthInsurance