frostedpink
Mouseketeer
- Joined
- Jun 22, 2012
Long story short, I was hospitalized. The doctor performed a surgery that the insurance company deems "investigative" and so they have denied that portion of the claim (that specific procedure code). Now what? The surgery is done, I was not warned ahead of time that insurance wouldn't cover it. It was a necessary surgery (a stent in my neck). But the procedure code is clearly defined as investigative by the FDA, so I'm confused why the doctor even did this procedure to begin with if they know most insurances won't cover it.
Shouldn't the hospital have checked first if it was an approved procedure? Or should I have been warned that it may not be covered?
I called the insurance company and they said the hospital billing department can do a "procedure code review". Will they automatically do that? And what if it's still the correct procedure? Now I'll be stuck with a huge bill?
Shouldn't the hospital have checked first if it was an approved procedure? Or should I have been warned that it may not be covered?
I called the insurance company and they said the hospital billing department can do a "procedure code review". Will they automatically do that? And what if it's still the correct procedure? Now I'll be stuck with a huge bill?