Insurace problems

Kimberly H.
on 6/4/03 7:05 am - Cisne, IL
My human resource person called my insurance to see about getting this surgery approved for me when she called she spoke with a lady that was very nice she said. She told her for pre determination I would need to get some information together and send it to them. I did everything that they asked for and more. After two weeks I called to see if they had recieved my papers. I tried to get ahold of the same lady they told me they didn't know her extention number or where to find her. So I talked to the lady on the phone and told her about it and all. She was like oh no that is not on your policy. I was like but the human resource lady and this other lady had a conversation about it. Told her what was said and she was like oh well I am sorry if she gave you any indication that this was covered it is not on your policy. Well I don't know what to do now I have a consult scheduled for a week and a half from today. What should I do ? PLEASE IF YOU HAVE ANY HOPE AT ALL FOR ME LET ME KNOW
Lisa F.
on 6/6/03 4:26 pm - Port Arthur, TX
Kimberly, Check your plan booklet if there is not a written exclusion ask them to provide WRITTEN proof that the service is not covered by your plan, give them a time limit to get the info back to you.If there is not a written exclusion and if they cannot provide proof of one then they can not use that as an excuse to deny you.Also make sure you keep a log of EVERYONE you talk to at the insurance company get first and last names time and date of calls that way when you speak with them you have specifics of who you talked to and what was said this will become very valuable if you have to appeal. Good Luck
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