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What Does This Health Insurance Denial Reason Mean?

Question by tballw32 | Posted in Insurance

"CT scans of pelvis, thorax and abdomen as separate procedures on the same day as the PET/CT fusion scan is not approved as these procedures are considered part of the PET/CT fusion scan and are already included under the code for the PET/CT scan.

Answer: It means that your hospital double billed for the same procedure, under two different codes.

Call your hospital billing department, and ask them to fix it - they either have to accept the payment for the PET/CT scan as payment for ALL of it, or rebill the insurance company correctly.
 
 

Does Any Candidate For President Believe Cigna Health Insurance Denial Of Liver Transplant Is Murder?

Question by valcus43 | Posted in Elections


Answer: I don't know about the candidates but I really believe this: If the young lady had been had been coveredunder some government funded insurance and this happened there would be rioting in the streets, and justly so. I think the ones responsible for denying her coverage should be charged and prosecuted.

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Health Insurance Denial For Treatment And "self-funded" Plan Rules?

Question by M | Posted in Other - Health

My doctor tried to get preauthorization for treating a medical condition of mine more than nine months ago. My insurance stubbornly denied it time after time after time. Between these “time after time” periods, the requests were lost in the mail (if you believe that), papers were ‘misplaced’ by them, and there were delays because of practically every little thing. Eventually, my case went to an external review board that ruled in my favor, over-turning the plans denial; the insurance has to pay for my treatment now. This ruling in my favor came just last week, the same week that my coverage with this health plan ended as a result of my COBRA continuation coverage expiring. I believe my

Answer: Many insurance companies will deny a claim simply to make you go away. In a self funded situation it may be that the employer wanted to stall until your COBRA ran out. My suggestion is that you contact an attorney regarding this. You have suffered needlessly for too long and the company has successfully kept your claim at bay. They have benefited by keeping their contributions to the fund at a minimum. This is why many self funded companies seem to have a much younger set of employees as well. Younger people usually have much less need of serious health coverage.

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Health Insurance Denial?

Question by Dilnoza A | Posted in Insurance

Hello. I have a brother who came to the US about 8 month ago. Couple month after he arrived we got him a health insurance. A month later, he started experiencing stomach problem. We went to a doctor and after doing an endoscopy they said he had H-Pylori. It was treated and everything was fine, until one day he got into a car accident and experienced a terrible stomach pain. We went to the emergency room and they did a CT scan to see if everything was fine. His insurance company claims that H-pylori was preexisting based upon what a doctor said could have been symptoms (which he never had). They are denying his car accident CT scan because it was stomach pain, which they think was preexisting.

Answer: Doesn't matter if he denies symptoms or not, doesn't matter if he was ever diagnosed in the old country or not. Some conditions just CANNOT develope overnight, and typically have symptoms.

He should file the car accident cat scan with his medical coverage on his car insurance.

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Health-insurance Coverage Denial Caused More Complications ?

Question by carolyn r | Posted in Other - General Health Care

My husband had this giant growth (bigger than basketball) on his inner thigh. He wanted to get it removed, but the insurance denied him (they felt it was cosmetic!!!)

Well, a few months later, this growth got super infected and it caused his entire system to get infected ("septic"), and he ended up in the intensive care unit (close to death) for 10 days. In addition to this health insurance, he also was a military vet. The military hospital had to cover the entire cost.

If he had been approved, this surgery would of been much less complicated and he would not have suffered so much.

What kind of attorney or law-firm covers coverage-denial?

Answer: There is nothing legal to do. Insurance companies have the discretion to deny or allow claims. If he was able to go to a military facility, he should have done that to start with (Not trying to be a wise acre, just telling it like the ins co sees it) Unfortunately there is nothing you can do. Now you know why millions of ppl die each year because they cant afford their medical bills.

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and have it readily accessible. » Life from the sport

by admin

All health insurance companies have a process in place by which plan members may appeal the decisions of the health insurance company. Lowe is a health care professional with 30+ years experience in the health care domain. Read the member handbook and/or policy and follow the procedure for appealing the denial of the claim. If providing also，again，and，besides documentation does not reresolve the dispute, then an appeal must be filed with the health insurance plan. She holds a graduate degree in health care....

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