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I have a question about Precertification?

JackieA
Posts: 150
Joined: Mar 2011

I discovered that my husband's chemo treatment did not get paid for for the past 2 months by our insurance company because the dr office did not obtain precertification. Has any one experience this? The insurance letter stated that the dr could not charge us for it. I am wondering if this is why suddenly my husband gets a break from chemo???? what do you think?

Cpnqueen
Posts: 29
Joined: Nov 2011

Jackie,
The doctors office knows how to deal with this. They will appeal and go from there. I don't think they would stop chemo for that, especially when it would be considered their error for not getting things approved first. My husbands insurance denied his hospiatal admission saying not medically necessary... which in my eyes was because of a coding error, but anyway I have been told over and over again that they are appealing and not to worry etc.. Little do they realize all the doctors and test are being denied too as a domino affect, but I will let them fight it out. I suggest you do the same. Let the doctors office appeal and as long as your letter states you are not responsible. Good Luck!

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