Dental insurance appeal letter
Common Questions and Answers about Dental insurance appeal letter
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made all payments, through 4/27/08, when the Cobra was due to end. On 4/29/08, I received a letter from my Cobra Insurance Co., saying that they were refunding my payments, from 7/1/07, as I was eligible for Medicare at that time. Of course, a huge stack of bills, totaling over 170,000 was included with the check. I am 64.
After researching, I find out that I had to elect Medicare B? I was never told this, and therefor I have no paperwork on it.
I recently broke a molar in my lower right quadrant, my dentist is recommending a root canal and a crown. My insurance company called me today to say it will not be approved because I'm over 21 yrs. I'm 56 year old female with no other dental issues. Doctors, what gives with this company? Is this normal and what can I do about it? Anyone else who have been through this issue and can offer some insight, I would appreciate your comments.
You doc should have said we are going to write a letter and make an appeal for you. They will overturn a denial. I got a denial and the next day my docs faxed a letter and gave reasons why. It was overturned and I had the Meds in a week. It was off-label S/O combo. I paid $100 a month copay. My question is did the office offer to send an appeal for you.
My husband is a prior non-responder to 3 previous treatments, most recent Triple tx with Incivek. G1a. Cirrhosis. His hepatologist wrote a prescription for Sovaldi-Olysio, and his insurance company denied it stating that it was investigational for prior non responders to Incivek. After the good results on this combo for prior non responders came out after EASL in London in April, his hepatologist appealed the insurance company's decision.
Hi Jlwhipple,
Welcome to our Pain Management Forum. Insurance companies.....don't get me started!! I understand that they are simply businesses. It is frustrating when you hurt and one medication works well in controlling your pain and your insurance company either won't cover it or covers only a fraction of the cost.
Yes Fentanyl Patches are expensive as compared to most other opiates. My insurance too only covers a fraction of the monthly cost.
Not an attorney but not sure this is the right way to go. Sometimes surgery has to be done, in spite of acute inflammation.
This was a medical decision made by your physician. He was there, and your insurance company was not. Shouldn't this be the argument around which you base your appeal?
I had a problem with our insurance not covering a prescription which I needed and my NS office was kind enough to write the insurance Co a letter sated you need it. I wish you the best. This is so flustrating. I guess people in your insurance doesn't know nothing about Chairi and how important this test would be for you. I don't understand why they would deny something that in the long run would save them some money. Best of luck.
Appeal the insurance decline. That happens often and approved on appeal. In the best interest of your wife...,refrain from tell others. Hepatitis C has a stigma that is far from going away. It's hard to prove where she got it. Unless a claim was made at the time of the accident. It would have had to be an event of exposer that was reported. There is help getting treatment. Take a deep breath and get as much info as possible about hep C.
Regarding getting a letter sent i saw a woman earlier this month and she examined me. she did not write a letter but i left her number for them to contact. would this not be suffice?
"What I can't understand and what Blue Cross is also likely not to understand is why the PT who provided you the first 24 sessions has now become unsuitable for continuing to treat you if you are given the go ahead to have more than the 24 sessions allowed.
Should I send a letter of explanation to my insurance company for an evaluation done at Columbia University? I had to pay $4,000 out of pocket for my evaluation and need to get reimbursed by my insurance. I'm wondering if it would be better just to send in the "bare bones," i.e., receipts and medical claim form without any explanation? I don't want to give them any reason to deny me....Any thoughts?
I have been diagnosed with myopic degeneration and receive the intraocular injection which is very effective. My insurance carrier will not cover the cost of the injection (medicine and surgery). If I had a diagnosis of macular degeneration it would be fully covered. I am looking for suggestions as to how to make my case with the insurance carrier that this is not a one time event but a chronic condition that if not treated would result in a loss of vision.
Before I went to the doctor I went to, I contacted Mayfield Chiari Center. Unfortunately they do not take my insurance. So out of network would only cover 50%. Say I do eventually want the surgery, since Chiari is somewhat rare and there are not enough doctors/centers that specialize, has anyone ever successfully petitioned their insurance company to pay it as in-network instead of out of network since we do not have many options/doctors to select from for treatment?
I had the MRI and now learn the facility is out of network and we owe $1000 (deductible since out of network). We are now on our 2nd appeal with UHC. In the appeal we will relay the above and note that they (UHC) admit that they have a “provider search” call logged on the day I made the appointment for the MRI (getting letter from facility verifying date appointment was made). However, UHC states they do not note what doctor or facility was searched during the logged call.
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