This is "the game" big insurance plays....unfortunately they DO deny first claims as most people do not question, do not ask again, intimidated and accept so many people believe Insurance people have unbridled power - ugh. My limited experience from being in the medical/ insurance world is to see first - denials (common). Recognize that at times you can be dealing with a 20-something year old who is only reading directives from a manual and just stamps "denied". Knowing that Mayo offers the same-price for 2 different procedures says they too know the game. One thing I know with a "game" is that "turns" go back and forth. Now it is your turn to engage.
Squeaky-wheels-do-get-the-grease.
The anger and frustration you feel (and justified) is fuel to take charge. I can say with confidence, the insurance company is hoping you will not question/challenge. There is always a higher step process.....ask/request.
Oh Kaitie - Sorry to hear your insurance company denied coverage for the proton radiation. I pray that Mayo Clinic will be able to submit additional information & your insurance company will approve it. 🙏❤️🩹
I know I “liked” this post. But I don’t actually “like” what health insurance is doing these days. Our healthcare teams know what’s best.
This is "the game" big insurance plays....unfortunately they DO deny first claims as most people do not question, do not ask again, intimidated and accept so many people believe Insurance people have unbridled power - ugh. My limited experience from being in the medical/ insurance world is to see first - denials (common). Recognize that at times you can be dealing with a 20-something year old who is only reading directives from a manual and just stamps "denied". Knowing that Mayo offers the same-price for 2 different procedures says they too know the game. One thing I know with a "game" is that "turns" go back and forth. Now it is your turn to engage.
Squeaky-wheels-do-get-the-grease.
The anger and frustration you feel (and justified) is fuel to take charge. I can say with confidence, the insurance company is hoping you will not question/challenge. There is always a higher step process.....ask/request.
Kaitie, You got this
You truly are - the strength.
I love you
Aunt Janie
Oh Kaitie - Sorry to hear your insurance company denied coverage for the proton radiation. I pray that Mayo Clinic will be able to submit additional information & your insurance company will approve it. 🙏❤️🩹