A Must Read for Insurance Denials

[Guest guest]

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