Insurance Woe
Hi everyone,
My name is Terry. I’m new to the group. I’ve been lurking for a
week or so, but now I have a question. I talked to my PCP, and he
agreed to refer me to the surgeon. I’ve heard about problems with
getting the insurance company to approve the surgery, but I have yet
to hear of anyone with this problem. Apparently, my insurance
company, Health Net, contracts with the medical group…they give
them funds to pay for certain things. Well, at this point, Health
Net and the medical group can’t agree on who will pay for the
consultation, etc… Health Net pays for the surgery if deemed
medically necessary, but they are in disagreement as to who pays for
the rest of it. Has anyone had this problem, and if so, is there
anything that I can do to help get the ball rolling? Thanks.
Terry
January 2nd, 2005 at 5:50 am
Hi everyone,
My name is Terry. I’m new to the group. I’ve been lurking for a
week or so, but now I have a question. I talked to my PCP, and he
agreed to refer me to the surgeon. I’ve heard about problems with
getting the insurance company to approve the surgery, but I have yet
to hear of anyone with this problem. Apparently, my insurance
company, Health Net, contracts with the medical group…they give
them funds to pay for certain things. Well, at this point, Health
Net and the medical group can’t agree on who will pay for the
consultation, etc… Health Net pays for the surgery if deemed
medically necessary, but they are in disagreement as to who pays for
the rest of it. Has anyone had this problem, and if so, is there
anything that I can do to help get the ball rolling? Thanks.
Terry