Re: A Must Read for Insurance Denials

[Guest guest]

GREAT info!!! I'm sure it'll help a lot of people!

Just hope that I can find something like that for the state of

Missouri now :)

> I am 8 days post-op and doing fairly well. I am posting a link

> address for some of you to use to help with insurance denials. I

> was denied by United Healthcare (in Florida), in fact my policy had

> a direct exclusion against my upper jaw surgery! My doctor was

> helpless against it and said my bill will be about $27K.

>

> However, he told me about a legal statute that many states have.

> The address below shows the one I found for Florida. In summary it

> states that a medical policy that covers other bones or joints can

> NOT discriminate against certain bones or joints like those of the

> face and jaw.

>

> Well, United told me they have an entire legal dept that screens

for

> this and I was probably wrong. So I sent the rep a link and within

> a couple of hours they told me I would indeed be covered. I ended

up

> with a $50 dollar copay for the surgery and may have to pay several

> hundred to the surgeon since he was covered at less since he was

out

> of my network. Not bad, from $27,000 to under $1,000 in less than

> one day's fight.

>

> This process is difficult enough without having to worry about

money

> and insurance companies red-tape.

>

> Good luck to all those having to deal with this.Here is my link,

you

> can find one similiar for your state through a google type search:

>

> http://www.flsenate.gov/statutes/index.cfm?mode=View%

>

20Statutes&SubMenu=1&App_mode=Display_Statute&Search_String=&URL=CH06

> 41/Sec31094.HTM

[Guest guest]

Thank you for this post. I never knew of this statute and hopefully

word will get out that this is wrong what they are doing.

> I am 8 days post-op and doing fairly well. I am posting a link

> address for some of you to use to help with insurance denials. I

> was denied by United Healthcare (in Florida), in fact my policy had

> a direct exclusion against my upper jaw surgery! My doctor was

> helpless against it and said my bill will be about $27K.

>

> However, he told me about a legal statute that many states have.

> The address below shows the one I found for Florida. In summary it

> states that a medical policy that covers other bones or joints can

> NOT discriminate against certain bones or joints like those of the

> face and jaw.

>

> Well, United told me they have an entire legal dept that screens

for

> this and I was probably wrong. So I sent the rep a link and within

> a couple of hours they told me I would indeed be covered. I ended

up

> with a $50 dollar copay for the surgery and may have to pay several

> hundred to the surgeon since he was covered at less since he was

out

> of my network. Not bad, from $27,000 to under $1,000 in less than

> one day's fight.

>

> This process is difficult enough without having to worry about

money

> and insurance companies red-tape.

>

> Good luck to all those having to deal with this.Here is my link,

you

> can find one similiar for your state through a google type search:

>

> http://www.flsenate.gov/statutes/index.cfm?mode=View%

>

20Statutes&SubMenu=1&App_mode=Display_Statute&Search_String=&URL=CH06

> 41/Sec31094.HTM

[Guest guest]

Thank you for this post. I never knew of this statute and hopefully

word will get out that this is wrong what they are doing.

> I am 8 days post-op and doing fairly well. I am posting a link

> address for some of you to use to help with insurance denials. I

> was denied by United Healthcare (in Florida), in fact my policy had

> a direct exclusion against my upper jaw surgery! My doctor was

> helpless against it and said my bill will be about $27K.

>

> However, he told me about a legal statute that many states have.

> The address below shows the one I found for Florida. In summary it

> states that a medical policy that covers other bones or joints can

> NOT discriminate against certain bones or joints like those of the

> face and jaw.

>

> Well, United told me they have an entire legal dept that screens

for

> this and I was probably wrong. So I sent the rep a link and within

> a couple of hours they told me I would indeed be covered. I ended

up

> with a $50 dollar copay for the surgery and may have to pay several

> hundred to the surgeon since he was covered at less since he was

out

> of my network. Not bad, from $27,000 to under $1,000 in less than

> one day's fight.

>

> This process is difficult enough without having to worry about

money

> and insurance companies red-tape.

>

> Good luck to all those having to deal with this.Here is my link,

you

> can find one similiar for your state through a google type search:

>

> http://www.flsenate.gov/statutes/index.cfm?mode=View%

>

20Statutes&SubMenu=1&App_mode=Display_Statute&Search_String=&URL=CH06

> 41/Sec31094.HTM

[Guest guest]

Thank you for this post. I never knew of this statute and hopefully

word will get out that this is wrong what they are doing.

> I am 8 days post-op and doing fairly well. I am posting a link

> address for some of you to use to help with insurance denials. I

> was denied by United Healthcare (in Florida), in fact my policy had

> a direct exclusion against my upper jaw surgery! My doctor was

> helpless against it and said my bill will be about $27K.

>

> However, he told me about a legal statute that many states have.

> The address below shows the one I found for Florida. In summary it

> states that a medical policy that covers other bones or joints can

> NOT discriminate against certain bones or joints like those of the

> face and jaw.

>

> Well, United told me they have an entire legal dept that screens

for

> this and I was probably wrong. So I sent the rep a link and within

> a couple of hours they told me I would indeed be covered. I ended

up

> with a $50 dollar copay for the surgery and may have to pay several

> hundred to the surgeon since he was covered at less since he was

out

> of my network. Not bad, from $27,000 to under $1,000 in less than

> one day's fight.

>

> This process is difficult enough without having to worry about

money

> and insurance companies red-tape.

>

> Good luck to all those having to deal with this.Here is my link,

you

> can find one similiar for your state through a google type search:

>

> http://www.flsenate.gov/statutes/index.cfm?mode=View%

>

20Statutes&SubMenu=1&App_mode=Display_Statute&Search_String=&URL=CH06

> 41/Sec31094.HTM