Ramhock Posted October 18, 2007 Share Posted October 18, 2007 I was welcomed home with a statement from our provider that there was no coverage for a recent outpatient procedure for my wife. Luckily, we don't visit the hospital too often and I think I may have gotten this because we didn't call ahead of time or at all for that matter. Customer service was closed til tomorrow. What are they going to tell me in the morning? Thanx in advance . . . I am due for a good night's slep. :keepingfingerscrossed: Quote Link to comment Share on other sites More sharing options...
Atlanta Cracker Posted October 18, 2007 Share Posted October 18, 2007 They'll probably tell you that there is no coverage... That just means you have to make them explain to you exactly why and how it could have / would have been covered and hope in the process they realize that in fact it should have been. Sometimes the flat out denial of coverage is something silly like missing a SS# on the claim or some other such error by the doctor so you can always hope for that as well. Quote Link to comment Share on other sites More sharing options...
Ramhock Posted October 18, 2007 Author Share Posted October 18, 2007 I know they request a call before things like that but it slipped our mind. I am hoping I will get away with some additional paperwork. We are very new with them. I am certain that it would have been covered as it was a necessary procedure, not elective or cosmetic. Quote Link to comment Share on other sites More sharing options...
Clubfoothead Posted October 18, 2007 Share Posted October 18, 2007 Did you get in the mail have "EOB" on it? If so, I think they are denying coverage. Quote Link to comment Share on other sites More sharing options...
Ramhock Posted October 18, 2007 Author Share Posted October 18, 2007 (edited) Did you get in the mail have "EOB" on it? If so, I think they are denying coverage. All EOBs = Requested info not rcvd from member. Sounds clerical to me. :wipesbrow: Thanx, Club, sometimes I am just too f'n lazy to read. Edited October 18, 2007 by Ramhock Quote Link to comment Share on other sites More sharing options...
TheShiznit Posted October 18, 2007 Share Posted October 18, 2007 All EOBs = Requested info not rcvd from member. Sounds clerical to me. :wipesbrow: Thanx, Club, sometimes I am just too f'n lazy to read. Ramhock....PM me tomorrow after you talk to the insurance company. I might be able to help. I will PM you my office telephone number or vice versa. Sometimes it is just a simple question you have to ask. Sometimes it is the docors fault for not getting the procedure pre-certified and the argument has to go to them. Sometimes the facility will accept usual and customery charges for the payment because they realize it was not your mistake. There are lots of things that can be done if this is an outright rejection of coverage. Quote Link to comment Share on other sites More sharing options...
Ramhock Posted October 18, 2007 Author Share Posted October 18, 2007 (edited) It was my son and not the wife, they just wanted to know if there was any other coverage and will now submit it. It's all about the float! Edited October 18, 2007 by Ramhock Quote Link to comment Share on other sites More sharing options...
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