Anonymous
Post 09/16/2025 08:06     Subject: fighting with insurance company over denied claim - next step?

Anonymous wrote:
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:I think we should all make it cost insurance companies more to deny claims for physician-ordered tests than it is to just pay them.

Call. Take up staff time — electronic communications won’t get it done. But always, always be nice to the people on the front lines. They aren’t the problem.

Make sure you know the diagnostic codes and billing codes when you call. I make my insurance calls while driving or doing housework or making dinner, to ensure that it doesn’t actually cost me valuable time.


It sounds like it wasn't denied. Rather, the OP didn't bother to wait until prior authorization was obtained.



this is accurate. I didn’t wait for prior authorization because the radiology clinic TOLD me very clearly that I could self-pay and submit to insurance - what I was waiving was their obligation to submit it. I then got authorization - I have an approval letter from the 3rd party that evaluates radiology orders for Cigna.


Is your approval letter backdated to the date you had your MRI ?


lol
Anonymous
Post 09/16/2025 07:09     Subject: fighting with insurance company over denied claim - next step?

Anonymous wrote:
Anonymous wrote:
Anonymous wrote:I think we should all make it cost insurance companies more to deny claims for physician-ordered tests than it is to just pay them.

Call. Take up staff time — electronic communications won’t get it done. But always, always be nice to the people on the front lines. They aren’t the problem.

Make sure you know the diagnostic codes and billing codes when you call. I make my insurance calls while driving or doing housework or making dinner, to ensure that it doesn’t actually cost me valuable time.


It sounds like it wasn't denied. Rather, the OP didn't bother to wait until prior authorization was obtained.



this is accurate. I didn’t wait for prior authorization because the radiology clinic TOLD me very clearly that I could self-pay and submit to insurance - what I was waiving was their obligation to submit it. I then got authorization - I have an approval letter from the 3rd party that evaluates radiology orders for Cigna.


Is your approval letter backdated to the date you had your MRI ?
Anonymous
Post 09/16/2025 00:43     Subject: fighting with insurance company over denied claim - next step?

Anonymous wrote:I expect my bill to be $1500-$2000 every time I into doctor's office even with good insurance. It all really is that expensive and complicated to navigate.
Pay the $500 as you time is more important.


You want families to fork over $30,000/year in premiums for "good insurance" that doesn't even cover office visits?

Good luck with that.