Reply to Ever file an appeal because of denial of coverage?

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[quote=Anonymous]I had a colonoscopy last year and they used "monitored anesthesia", not by my request, but by routine procedure/doctor's request. Insurance wants me to pay the $460 extra for this, as it is "not medically necessary". They feel anesthesia (just the IV sedation part is all that should be done) for this procedure doesn't require the extra leads attached to the patient's body to monitor heart rate/rhythm. I did an internal appeal and was denied coverage, and am going for the external review/appeal now. There is nothing extra that can be added to the stack of info already in the pile of papers they will get, including a wonderful letter from the gastroenterologist who did the procedure. I was going to add my own letter, nicely worded, that monitored anesthesia is routine at this facility, and that this is really an argument between the physician and the insurance, with me stuck in the middle. All the other patients at this place get monitored, so why the denial? Anyway, I am just wondering if anyone has added their own $0.02 as a last resort, and how'd it all turn out. The balance ($460) has already gone to a collection agency, too.[/quote]

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