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Cosmetic Surgery?

Posted: Wed Feb 20, 2002 11:50 am
by francine
Our health insurance company has just informed us that Maia's capsulodesis surgery was cosmetic and that they will not pay for it!

isn't THAT interesting??

needless to say I've rewritten the letter 9 times to tone it down...

amazing huh?

Re: Cosmetic Surgery?

Posted: Wed Feb 20, 2002 11:59 am
by njbirk
Yes it is amazing.
Poor sops, don't they realize who they are dealing with? LOL

I spend a part of every day, it seems, fighting with my insurance company. Since I have both primary (my insurance) and secondary (my husband's insurance), everything should be fully covered. But inevitably, mostly because of incompetence, problems occur. It can really get me going however, because it is such a waste of my time.

Right will win out however, and we are right, so never stop fighting and appealing.

Nancy

Re: Cosmetic Surgery?

Posted: Wed Feb 20, 2002 12:17 pm
by francine
Nancy - LOL

Tina - did YOU get your letter yet? or did they just want to get a rise out of me? LOL

Re: Cosmetic Surgery?

Posted: Wed Feb 20, 2002 12:23 pm
by NancyP
This surgery is probably our next step. We are just waiting for x-ray results. Did they say why they classified it as cosmetic? Has any one else been denied?

I have to fight insurance EVERY time we need something. Therapy, surgery, equipment..... It is so frustrating.

Hang in there and fight the good fight!

Re: Cosmetic Surgery?

Posted: Wed Feb 20, 2002 12:30 pm
by francine
Here's the thing Nancy - it was pre-approved and it was pre-certified by two separate offices within the insurance company. No hospital does surgery with a pre-cert! So I'm not not upset about the letter itself- I'm upset that I have to waste my time fighting their stooopid mistake.

Re: Cosmetic Surgery?

Posted: Wed Feb 20, 2002 12:45 pm
by NancyP
What a pain. Don't you feel like you could go in and do their jobs sometimes? I know more about insurance processes than I ever wanted to, and sometimes have to correct them on their own mistakes.

Kelsey's last surgery was "officially" approved at 8 am the day before surgery. We had been on the road for 3 hours to Houston. I am dreading getting the pre-cert on this next one.

Bill's been paid! LOL

Posted: Wed Feb 20, 2002 12:46 pm
by francine
Finally got through to claims and it's been paid already. LOL yeeesh... all those letters to waste now...hehehe :)


Re: Bill's been paid! LOL

Posted: Wed Feb 20, 2002 1:53 pm
by browning93
SO GLAD TO KNOW I'M NOT ALONE!!!!! LEEANNE