Re: Insurance Companies claudia

[Guest guest]

Not sure, but I think that part of the letter may be a standard paragraph in all of the letters. It more or less will cover them incase the dr. office or hosp. does not file the correct insurance forms, like the wrong codes on them or diagnosis. If that happens then dr's office has to refile the forms with the correct info on them. This has happened to me too. But if i were you then I would call to make sure.

dawn

RCColloran@... wrote: Well, I have just about had it with insurance companies! Am I not alone here?? LOL We all know the games that they play and how maddening they can be, but I have run into something new. Maybe it's routine, but I have never dealt with it. I received a letter yesterday telling me basically that I have done everything right with my upcoming surgery. I am going to a covered provider and they listed what I was having done, the dr etc. Then they added another paragraph. They said even though I had done everything right, they couldn't guarantee payment of claims. What is that??? They said that there might be somethings that won't be covered and that when it goes to the review for payment it might not have been deemed necessary. Oh it went on giving all the reasons that they might not pay, but never said specifically what they were. Covering their butt in case they don't want to pay the BIG bill. I think this is uncalled for by sending it a week or two before someone has surgery. Hey, I would prefer to know after. LOL A lot less worrying. I will call tomorrow and see if they can be more specific, but I doubt they will. LOL Just wondered if anyone has ever ran into this problem. I thought if you were approved that it was all covered. Now they are saying it might be a pre existing condition, etc. Geez..... where's the doc's that came to your house??? LOL