Guest guest Posted October 22, 2004 Report Share Posted October 22, 2004 It's me again... almost 4 month later... UHC denied my first appeal... Dex Media didn't want to provide us with a handbook showing the supposed exclusions that didn't previously exist. My husband contacted CWA - the union for Dex. Needless to say, Dex Media's HR department has finally taken our complaint seriously! My husband started getting someone with HR. They sent several emails and the last one was an email that they forwarded from United Healthcare. It confirmed what we have been saving... there was a glitch in the system and the denial was a MISTAKE... my surgery is still approved! Now we are waiting for the new APPROVAL letter so that I can finally get this surgery scheduled, done, and behind me. Remember, I was originally scheduled to get a LeFort done almost 1 year ago, on 12/31/03. ~ S. > > > > > Hello, My name is dan and I will have lower advancement in > > about > > > 1 > > > > > month or so. I just talked to my oral surgeon today and was > > > getting > > > > > some particulars about payment. My insurance is > > > > Bluecross/blueshield > > > > > federal plan. My insurance will not give a pre authorization > > for > > > > this > > > > > surgery. My doctor today told me that I would have to pre > pay > > > for > > > > the > > > > > hospital and for anethsia. which is around $6,000. They said > > > since > > > > I > > > > > am pre-paying it will not go thru insurance and that will be > > out > > > of > > > > > pocket for me. They said if I dont pre pay and submit to > > > insurance > > > > > and it is denied i would be looking at around a $14,000 > > hospital > > > > bill > > > > > alone. This does not sound right to me. Has anyone had any > > > > experience > > > > > with this before or have this kind of insurance? I Really > need > > > help > > > > > on this one. My the fee for surgery will be around 6,000 of > > > which > > > > my > > > > > doctor wants me to pre pay a portion of also. > > > > > > > > > > Thanks > > > > > > > > > > Dan Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 22, 2004 Report Share Posted October 22, 2004 It's me again... almost 4 month later... UHC denied my first appeal... Dex Media didn't want to provide us with a handbook showing the supposed exclusions that didn't previously exist. My husband contacted CWA - the union for Dex. Needless to say, Dex Media's HR department has finally taken our complaint seriously! My husband started getting someone with HR. They sent several emails and the last one was an email that they forwarded from United Healthcare. It confirmed what we have been saving... there was a glitch in the system and the denial was a MISTAKE... my surgery is still approved! Now we are waiting for the new APPROVAL letter so that I can finally get this surgery scheduled, done, and behind me. Remember, I was originally scheduled to get a LeFort done almost 1 year ago, on 12/31/03. ~ S. > > > > > Hello, My name is dan and I will have lower advancement in > > about > > > 1 > > > > > month or so. I just talked to my oral surgeon today and was > > > getting > > > > > some particulars about payment. My insurance is > > > > Bluecross/blueshield > > > > > federal plan. My insurance will not give a pre authorization > > for > > > > this > > > > > surgery. My doctor today told me that I would have to pre > pay > > > for > > > > the > > > > > hospital and for anethsia. which is around $6,000. They said > > > since > > > > I > > > > > am pre-paying it will not go thru insurance and that will be > > out > > > of > > > > > pocket for me. They said if I dont pre pay and submit to > > > insurance > > > > > and it is denied i would be looking at around a $14,000 > > hospital > > > > bill > > > > > alone. This does not sound right to me. Has anyone had any > > > > experience > > > > > with this before or have this kind of insurance? I Really > need > > > help > > > > > on this one. My the fee for surgery will be around 6,000 of > > > which > > > > my > > > > > doctor wants me to pre pay a portion of also. > > > > > > > > > > Thanks > > > > > > > > > > Dan Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 22, 2004 Report Share Posted October 22, 2004 , I too work for qwest and have uhc. My claim was preapproved the first submission. I was shocked. I just had the surgery Oct12. The only thing I have paid so far is my co-pay for the first 5 visits after that they dont take co-pay. I havn't gotten my bill from the hospital, but I expect that to be $150. I hope this helps. I am sory they denied your claim and made you freak out for no reason. > > > > > > Hello, My name is dan and I will have lower advancement in > > > about > > > > 1 > > > > > > month or so. I just talked to my oral surgeon today and was > > > > getting > > > > > > some particulars about payment. My insurance is > > > > > Bluecross/blueshield > > > > > > federal plan. My insurance will not give a pre > authorization > > > for > > > > > this > > > > > > surgery. My doctor today told me that I would have to pre > > pay > > > > for > > > > > the > > > > > > hospital and for anethsia. which is around $6,000. They > said > > > > since > > > > > I > > > > > > am pre-paying it will not go thru insurance and that will > be > > > out > > > > of > > > > > > pocket for me. They said if I dont pre pay and submit to > > > > insurance > > > > > > and it is denied i would be looking at around a $14,000 > > > hospital > > > > > bill > > > > > > alone. This does not sound right to me. Has anyone had any > > > > > experience > > > > > > with this before or have this kind of insurance? I Really > > need > > > > help > > > > > > on this one. My the fee for surgery will be around 6,000 of > > > > which > > > > > my > > > > > > doctor wants me to pre pay a portion of also. > > > > > > > > > > > > Thanks > > > > > > > > > > > > Dan Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 22, 2004 Report Share Posted October 22, 2004 , I too work for qwest and have uhc. My claim was preapproved the first submission. I was shocked. I just had the surgery Oct12. The only thing I have paid so far is my co-pay for the first 5 visits after that they dont take co-pay. I havn't gotten my bill from the hospital, but I expect that to be $150. I hope this helps. I am sory they denied your claim and made you freak out for no reason. > > > > > > Hello, My name is dan and I will have lower advancement in > > > about > > > > 1 > > > > > > month or so. I just talked to my oral surgeon today and was > > > > getting > > > > > > some particulars about payment. My insurance is > > > > > Bluecross/blueshield > > > > > > federal plan. My insurance will not give a pre > authorization > > > for > > > > > this > > > > > > surgery. My doctor today told me that I would have to pre > > pay > > > > for > > > > > the > > > > > > hospital and for anethsia. which is around $6,000. They > said > > > > since > > > > > I > > > > > > am pre-paying it will not go thru insurance and that will > be > > > out > > > > of > > > > > > pocket for me. They said if I dont pre pay and submit to > > > > insurance > > > > > > and it is denied i would be looking at around a $14,000 > > > hospital > > > > > bill > > > > > > alone. This does not sound right to me. Has anyone had any > > > > > experience > > > > > > with this before or have this kind of insurance? I Really > > need > > > > help > > > > > > on this one. My the fee for surgery will be around 6,000 of > > > > which > > > > > my > > > > > > doctor wants me to pre pay a portion of also. > > > > > > > > > > > > Thanks > > > > > > > > > > > > Dan Quote Link to comment Share on other sites More sharing options...
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