Question:
Ins denied verbally and refuses to send me letter denying
They won't even give me a benefit booklet. I have Highmark BCBS. Any suggestions or letters I can use when they deny verbally? — Samathal8585 (posted on March 26, 2008)
March 26, 2008
Is it your insurance or are you the dependent of another? If it's your
insurance, I think by law they have to provide you with a benefit booklet.
If you are a dependent of someone else's policy, then they may have to
request it.
— Dave Chambers
March 26, 2008
First, the policy holder has to call them or the insured. If you are a
spouse of the insured, then have your spouse call them. They have to give
you a policy booklet, and they have to allow you to appeal the denial.
Start by having your doctor check on your coverage. If you have not
selected a sergeon, do so and ask them to do the requist for coverage.
tehn they will send him and you or the policy holder a letter as to the
reason. The doctor will know if you have to prove other issues to have the
surgery, like High Blood Pressure, dieabities, etc. The only way they can
denial all coverage if there is a statement that says "No Baratric
coverage will be allowed regardless of the patients issues" Then you
can got to www.obesitylaw.com and ask them to assist you.
— William (Bill) wmil
March 26, 2008
I have Highmark BC/BS. Get your insurance card, go to
www.highmarkbcbs.com, go to "manage your plan" sign up with your
ID and Group number; you can view your entire Benefit Booklet or print it
out.
— MiniMello
March 26, 2008
I also have this insurance and they sent me a letter and my doctor's office
took care of it from there. best of luck
— Alvernlaw
March 26, 2008
Every state has a gov't department that regulates Ins. Call the Ins let
them know you will contact the reg. agency. That is usually all it takes.
If not, file a complaint they have 30 days to make it right.
— Donna O.
March 28, 2008
The best place to go is to your doctor's billing employee. They definitely
know why your insurance denied you. Also, consider using a self-pay
process with financing.
— jennycad
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