I am a bit confused and hoping someone might be able to help me... DH called his benefits coordinator at work today and was told that a specfic treatment is not covered under his insurance plan, however, when he called his insurance company directly he was told that it is. We are not sure who to believe. Have you ever heard of anything like this, and if you were me, who would you believe more?
Shorty McBride
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Member since
Re: Anyone work in insurance industry?
I don't work in the insurance industry, but I do insurance verification/deal with insurance at a medical office.
I ALWAYS get conflicting info from employers and the insurance companies directly --- I would get a supervisor @ the insurance co on the phone ASAP, or even see if the Doctor's office will call in the co. for you.
What insurance company? Maybe I can help further w/ some secret phone #s I know!
lilmrs
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Re: Anyone work in insurance industry?
OOh that would be great. He has an HMO through Aetna. THANK YOU THANK YOU THANK YOU!
Shorty McBride
Posted:
Member since
Re: Anyone work in insurance industry?
hm...they're usually not bad. I don't however, have any secret/direct #s for Aetna.
DEFINITELY get a supervisor on the phone - I don't see why Aetna wouldn't cover it, as long as the MD and anestaesiologist (i think I butchered that word) are participating providors...
Xelindrya
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Member since
Re: Anyone work in insurance industry?
I agree with the suggestion.
PS: You should rename the post Health Insurance Industry.
I'm in P&C (property and casualty) and it's totally different.
Good Luck!!!
I had the same thing happen with me once with Aetna.. ya really got to hold out!
exotica776
Posted:
Member since
Re: Anyone work in insurance industry?
the safest thing to do is to have the doctors office submit a pre authorization for you. it is the 'safest' way to handle this situation (assuming there is not an immediate rush on the procedure). I am an office manager for an oral surgeon and deal w/ all types of dental/medical insurance companies, whenever i am unsure of the benefits, i always submit a pre-auth. HTH
