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Old 12-12-2015, 07:37 PM
3 posts, read 8,981 times
Reputation: 12


I had a very expensive laser procedure completed on all four quadrants of my gums .I spent 7 months trying to get the procedure approved ..and finally got my per approval letter .The insurance company called my personally to tell me it's finally taken care of .I took a loan when I had the treatment done ..and paid my part in full .Now I am getting bills stating the insurance is denying it .Can I legally be held responsible for this ?
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Old 12-12-2015, 07:41 PM
Location: Out there somewhere...a traveling man.
40,622 posts, read 50,596,575 times
Reputation: 114244
If you got an approval letter then send a copy of it back to them with the billing statement. That's your proof as long as it's in writing. Phone call approvals mean nothing.
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Old 12-12-2015, 10:00 PM
1,552 posts, read 1,939,048 times
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It sounds like you got a "pre-authorization". At the bottom of every pre-authorization is the fine print that says "this is not a guarantee of payment" which means they reserve the right to change their minds later. This is VERY common and is a way the insurance company makes profits by collecting your premiums then not paying for services. You need to protest loudly to your insurance company. YOU are the customer and they will only listen to the customer (not the doctor). This is between you and the insurance company. The only reason they get away with this and keep doing it is because the customers do not complain and blame the doctor's office, and because the customer keeps paying premiums. If they are still getting their premiums then they have no reason to change.
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