(Closed) Evil health insurance woes; do you have experience? advice?

posted 7 years ago in Legal
Post # 3
Member
3692 posts
Sugar bee
  • Wedding: December 2011

I worked in health insurance for 5 1/2 years, and I’m stumped on this one.  I recommend calling your state’s department of insurance and filing a complaint.  The place I worked for took DoI complaints very seriously.  

Was this one of the big insurance companies, or a fly-by-night thing?  Sometimes doctors do drop off from those networks because they don’t need the extra business, or because the companies are such a hassle to deal with.  But they should have updated their network website to reflect that.  

It’s kind of weird that the doctors’ offices didn’t say anything when you handed them your insurance cards and it was for something they didn’t participate in.  

Post # 4
Member
116 posts
Blushing bee

Are you in an HMO or managed by a Physician’s Group? If the doctors are in the list that the insurance company provided you, then I would appeal the decision. You have no idea how many times the claims department gets these things wrong. Also, if you really want to see a certain doctor, and the doctor’s office has competent front of office staff, they can request for an “out of network referral” since there aren’t any providers within your area.

Post # 5
Member
67 posts
Worker bee
  • Wedding: May 2012

Ouch! I don’t have any advice 🙁 My insurance denied my doctor prescribed mammogram (she FLINCHED at my breast exam) because I’m under 35 and therefore have no “right” to have breast cancer. I was supposed to have an ultrasound exam of my breasts, since I’m young and they’re dense. Hospital tech opted for the mammo, though I don’t think that’d made a difference on the coverage.

My roomie is in the insurance biz and basically says, “It’s not in their business interest to cover you. They’ll find every excuse possible.” ugh!

The topic ‘Evil health insurance woes; do you have experience? advice?’ is closed to new replies.

Find Amazing Vendors