..............................

[C.Ann]

---------------------------

 

[golfgal]

Often there are coding mistakes for these things so check into that. Also, it isn't the insurance company that makes these decisions as to what is covered or not, it is the owner of the policy, so if you have a policy through work, your company is ultimately responsible for what is covered and what isn't.

 

[C.Ann]

-----------------

 

[we3disneygo]

were going thru the same thing--dh had a mri, it was pre approved, etc. and the cruddy insurance co. won't pay.....we have appealed, had the dr. write a letter, they won't budge, we are still trying to straighten the mess out, and yes you wonder what your paying for each month when they never come thru for you....

 

[Disney Doll]

I have two words for you...insurance commissioner.

I used to work for a health insurance company and believe me, they hate it when the IC comes a callin' because he tends to find more than what was the initial complaint.

 

[C.Ann]

..............

 

[honeymom]

I think that there are still people that have good insurance companies with good benefits that do not understand that this goes on. I am self-insured also, (we are self employed) and it can be horrible. Yes, the state commissioners can help (I brought one situation to the attention of my state commissioner when I lived in Connecticut), but it is very time consuming and chances are you will not get an answer quickly enough to resolve this situation. In my case, I had a policy that would not pay for ADD and of course my daughter had ADHD. But, I lived in a mental health parity state which required that any mental health problem that had a legitimate psychiatric coding (there is some publication) be covered. While ADD was not covered, my daughter had the H (ADHD) which was supposed to be covered. I did get them to cover some expenses, but got so tired of going after them on some of it that I walked away from about $300 rather than spend any more time collecting. I did find out that although I was using a big name insurance company, the Connecticut State Commissioner had a number of issues with them and was only too happy to hear the details of my situation.