Reply to Insurance Denied Coverage for Medical Equipment

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[quote=Anonymous]If anyone has advice on how to proceed, I would appreciate it.

My mom's neurologist and pulmonologist both recommended a BIPAP.  With each breath my mom is only getting 40% of the volume of air that she needs to be getting.  Someone, my mom is confused as to who, called my mom yesterday and told her the insurance company denied the request for a BIPAP.  She didn't understand anything else that they said.

I think the first stop is to figure out who called my mom and get more details from them.

If the insurance company really did deny the claim, I'm a bit at a loss as to how they could do that.  Obviously I need to understand my mom's insurance plan better.  She has what she thought was "the good" Medicare plan.  Her specialists said she needs this machine to breath better.  How could this be denied?

FWIW I did look into her just renting the machine herself so she wouldn't have to wait for insurance to review and approve the request.  The company I called said they would only rent that to someone who had been approved by insurance, so basically we can't get what my mom's doctor's prescribed without insurance's approval, even if she were willing/able to pay for it completely herself.  This seems crazy!  (Yes, I am relatively new to elder care issues).

Thank you for any insights or suggestions.

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