Feb 20, 2014 - 4:34 pm
It's beginning to look like I've been thrust into what may be common nowadays. I had my scan in January under the new insurance....remember I had to cancel my appointment, and make a new one in a different town, because the local imaging center wasn't in my network....ok...did that. Also it was pre-authorized by the Drs.' office, and I thought we were good to go. This wasn't a PET, it was a CT with and without contrast.
I got my EOB yesterday from the new insurance company.....For the Scan they have it coded that "Charges denied. Need documentation of medical necessity."
For the contrast they have "Charge not medically necessary".
I am SO upset! Why would they authorize it, then deny it? Is this the new way, maybe....that every time you do something they make you fight for it in hopes you'll go away and pay for it yourself? I don't have any clue how to go about fighting this....do I go to the Oncologist's office and talk to them? Do I just work with the insurance company? So far with this new insurance every thing is coming out of my pocket.....the ENT isn't in the network (and he's the only one within 200 miles).....the imaging center isn't in the network, and neither is the butt Dr. The insurance company doesn't have any problem, of course, taking $600 a month out of my pocket.
If anybody knows how to get this started, just the first footsteps, I'd be ever so grateful.