Insurance

[syrabeth]

My insurance company is starting to reject my claims because the doctor's keep doing the same test over and over. Even though I tell them that the urine will not culture. Is there anything that I can do?
-Sarah

[Goldfinch]

Often an insurance provider will automaticaly red-flag certain procedures if they deem them unnecessary or duplicate. It doesn't mean that you can't over-ride the decision, but sometimes it does involve some annoying telephone calls and a bit of time. If you haven't already talked with the insurance co. you should. First, find out if there are any "patient reps" at your insurance co. that you can talk to. If not, talk to whoever. Explain the situation and find out what the procedure is to reverse their decision. Sometimes it's simply a matter of the doctor filling out a form to authorize the tests or of someone writing a note of explanation.

I've spent many frustrating hours dealing with my insurance company over the years trying to get some of my daughter's health care needs met and now mine. Out of the blue my provider decided not to cover Elmiron and Urelle. There was a fairly simply way to resolve it, but let's just say insurance providers tend to do whatever they can to cut costs and don't give you much warning. Then they let the patient do all the work to figure it out. Just one more source of stress for those of us at the mercy of an inadequate health care system.

[omarito]

i think u should take a claim from ur doctor to the insurance company about ur case and the neccesity of doing those tests many times.