General Discussion

adirondacker

(2,921 posts)

19. Medical insurance companies ALWAYS look for a reason to decline a payment. When I worked as an

Wed Mar 5, 2014, 02:30 PM

Mar 2014

"approver" we scoured for anything on the bill for a reason to decline. Approvers are rewarded on how many claims processed per work day. The average was 100-125 claims per day. If you processed less, you were terminated.

The advice I can offer you is make sure you have a legitimate diagnosis from the Dr. that performed the services.
and make sure the services are Not treated as "preventative medicine". Also make sure EVERYTHING is filled out correctly. Signatures, diagnosis, treatment, dates. If there are questions call the ins company, but don't offer up any incriminating statements. Make sure you document the person you spoke with and time and questions posed.

They are probably denying you coverage for "preventative medicine", when in it should be covered as "treatment and follow up treatment for raccoon bite". Bring this to the attention of the Dr's office or ER that performed this, and they should be able to correct the information.

You should be able to push this through Aerows. Sorry to hear that you have to go through this and best wishes.

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Health care costs in the US are completely reasonable [View all] Aerows Mar 2014 OP

$18,000 for just your rabies series? Autumn Mar 2014 #1

I was stunned Aerows Mar 2014 #4

It was $5,082 two years ago: jsr Mar 2014 #2

I got the nasty one where they inject it directly into the wound Aerows Mar 2014 #3

It was $13,000 four years ago for my uncle in Atlanta. stillwaiting Mar 2014 #6

thats about what it was for us two years ago belcffub Mar 2014 #22

Easy money. I don't know why everybody JEB Mar 2014 #5

My mind is officially blown Aerows Mar 2014 #7

Oh, and icing on the cake? Aerows Mar 2014 #8

I thought under the ACA they had to cover stuff like this rurallib Mar 2014 #9

This is insurance before the ACA Aerows Mar 2014 #10

On what grounds? Warren Stupidity Mar 2014 #12

I'll get the letter Aerows Mar 2014 #14

Rabies is a 99.9999 fatal disease, Warren Stupidity Mar 2014 #15

If I knew this was coming? Aerows Mar 2014 #16

Send them $500 and a note saying JEB Mar 2014 #20

WTF. I know for a fact that Medicare covers rabies shots if you're bitten by a dog. jsr Mar 2014 #17

!!!! Whisp Mar 2014 #11

My jaw has been on the floor since I opened both Aerows Mar 2014 #13

First make sure it was billed correctly Sweet Freedom Mar 2014 #18

Medical insurance companies ALWAYS look for a reason to decline a payment. When I worked as an adirondacker Mar 2014 #19

not sure where you are from belcffub Mar 2014 #23

Of course they are, good that you now agree nadinbrzezinski Mar 2014 #21