Insurance approval, then a later denial? *please read*

[Guest guest]

Hi guys,

I have an insurance question for you. We started the process with in July--our Cranial Tech office was kind enough to do all the insurance paperwork for us and even got our company to cover the band in-network at 90%. We paid our 10%, did the casting, got the band, blah, blah, blah. CT still has not gotten paid by the insurance company (United Healthcare) and it's now October.

I had already called back in August to check on the status and they said they needed more information...did I have any other insurance coverage, etc. They said they would resubmit the claim at that time. No payment yet.

I called again today and they are now telling me that the claim is going through a "review" process, whatever that means, because it's for medical equipment. I told the lady that they had already approved us at 90% prior to the start of treatment. She says this is standard procedure for this type of claim. I'm scared to death.

Can they give us an approval and then months later, once treatment has started, decline to pay their share? Has this happened to anyone here? If so, what did you do??

Kerri & Baby (Chicago)