312416
United States of America#2Consumer Suggestion
Mon, December 10, 2012
As a insurance policy holder, you have the right to file an appeal. Call your customer service number on your member ID and tell them you want to file an appeal. There are several levels of appeals. The first being a multi-displinary team who reviews your case. They will vote on if your case should be overturned. If this outcome isn't in your favor, you can file again. There will be a review of your case by outside independent physicians. This is a very useful process and I highly recommend you pursuing.
Do-do
Roseville,#3Consumer Suggestion
Sat, December 08, 2012
For some reason, insurance companies are issuing policies (of certain types...but not all categories, apparently) that specifically and singularly exclude coverage for spine surgery. I just happen to become aware of this while changing the deductuble and coverage on my policy to avoid astoundingly increasing premiums. You need to look at your policy to see if this is excluded. His disc surgery will cost him a lot. But he shouldn't wait 3 months against his neurosurgeons' advice; compressed nerves often become irreparably damaged leading (of course) to a permanent deficit.
It wouldn't be a bad idea for him to contact his state insuance commission. Nothing to lose.