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BaroqueMama
Chase is one!
Member since 5/05 27530 total posts
Name:
me
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I just got a letter from my insurance...
and I'm freaking out because I cannot get a hold of them till Tuesday. It says that my last sonogram was not covered under my insurance. I'm totally flipping.
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Posted 1/13/06 7:23 PM  |
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Corinne
My munchkins
Member since 5/05 5010 total posts
Name:
corinne
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Re: I just got a letter from my insurance...
i wouldnt freak out it could be the way that the doctor submitted it. i had a problem with my dentist and they submitted it incorrectly. I would go to the insurance website and check to see whats covered before you get worried. Im surprised they are not opened tomorrow usually they have a care line on saturdays.
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| Posted 1/13/06 7:28 PM |
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mishy
My Girls
Member since 10/05 2427 total posts
Name:
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Re: I just got a letter from my insurance...
The same thing happened to me, I am considered a high risk preggo so I had this test done every 2 weeks called a Fetal Fibronectin, to make sure I wasn't going to go into labor within 2 weeks, the test was 485 each time and each time they sent a letter, but insurance did cover it... Good Luck!!!
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| Posted 1/13/06 7:37 PM |
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anon
where's winter?
Member since 11/05 2209 total posts
Name:
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Re: I just got a letter from my insurance...
ug! i totally see this happening to me...
what insurace do you have?
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| Posted 1/13/06 7:42 PM |
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BaroqueMama
Chase is one!
Member since 5/05 27530 total posts
Name:
me
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Re: I just got a letter from my insurance...
I have aetna. It came back as a service from a non-contracted provider, however, the sono was done in my dr.'s office by the same person who did my first sono, and that was covered. Unfortunately, there is no list on the website as to what is covered. how stupid is that?
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| Posted 1/13/06 8:34 PM |
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CathyB
Member since 5/05 19403 total posts
Name:
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Re: I just got a letter from my insurance...
My girlfriend ran into this problem recently. They weren't going to cover her 20 week, b/c they said she'd already had 4, when she only had 2. Turns out they were counting the ones she had from a previous pregnancy that ended in miscarriage over 12 months ago. Once she pointed out it would be impossible to be pregnant that long and there was a D&C in between they said they'd pay for it.
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| Posted 1/13/06 8:36 PM |
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BaroqueMama
Chase is one!
Member since 5/05 27530 total posts
Name:
me
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Re: I just got a letter from my insurance...
Yeah, I guess I just need to call. It could be a million things. That's so horrible though that your friend had to deal with that.
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| Posted 1/13/06 8:40 PM |
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Corinne
My munchkins
Member since 5/05 5010 total posts
Name:
corinne
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Re: I just got a letter from my insurance...
the office probably invoiced it incorrectly if its showing up as non contracted. sometimes they bill it differently so they can make more money. got to love it.
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| Posted 1/13/06 10:54 PM |
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anon
where's winter?
Member since 11/05 2209 total posts
Name:
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Re: I just got a letter from my insurance...
Posted by prncssrachel
I have aetna. It came back as a service from a non-contracted provider, however, the sono was done in my dr.'s office by the same person who did my first sono, and that was covered. Unfortunately, there is no list on the website as to what is covered. how stupid is that?
i have aetna as well and have had 4 ultrasounds already with this pregnancy and have a 5th scheduled in 2 weeks and i'm only starting my 20th week today.
i have yet to receive ANY bills for ultrasounds and am worried they are going to pull "you only have X allotted under the plan" even though it was the dr. who requested i come back twice because they couldn't see/measure what they needed.
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| Posted 1/14/06 9:29 AM |
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Re: I just got a letter from my insurance...
I have Aenta too and I had so many sonograms, I lost count. They were all covered. Give them a call to see why it was denied. I am getting bills from when Hayley was in NICU, I call and they pay them.
Good Luck!
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| Posted 1/14/06 10:27 AM |
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BaroqueMama
Chase is one!
Member since 5/05 27530 total posts
Name:
me
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Re: I just got a letter from my insurance...
Thanks girls, you are making me feel better! We picked this insurance for the fact that it seemed to cover just about everything, so I started to freak when I thought they might not cover basics like this. Thanks again!
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| Posted 1/14/06 10:49 AM |
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robcoll1002
My Beautiful Babies
Member since 5/05 2073 total posts
Name:
Colleen
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Re: I just got a letter from my insurance...
I can try to help you. I am a medical biller. If you look on the EOB (explanation of benefits) there should be a code next to the code your doctors office billed. When you see that code the explanation should be at the bottom of the page. If it says that it is a non covered provider then there maybe a doctor in the practice that doesn't take Aetna or just isn't on the plan yet and your office made a mistake by billing it under that doc. Also take a look at an EOB from before that would have a sono listed on it and see if they used the same code to bill.
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| Posted 1/14/06 11:40 AM |
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BaroqueMama
Chase is one!
Member since 5/05 27530 total posts
Name:
me
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Re: I just got a letter from my insurance...
Posted by robcoll1002
I can try to help you. I am a medical biller. If you look on the EOB (explanation of benefits) there should be a code next to the code your doctors office billed. When you see that code the explanation should be at the bottom of the page. If it says that it is a non covered provider then there maybe a doctor in the practice that doesn't take Aetna or just isn't on the plan yet and your office made a mistake by billing it under that doc. Also take a look at an EOB from before that would have a sono listed on it and see if they used the same code to bill.
Thank you for the help! I will check it out.
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| Posted 1/14/06 12:22 PM |
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dm24angel
Happiness
Member since 5/05 34581 total posts
Name:
Donna
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Re: I just got a letter from my insurance...
I work for a large insurance company, Let me give you some advice.
First, if you get anything denied you feel shouldnt be...Dont freak out.. CALL THEM. Insurance companies are run by humans who make mistakes. Image that they get over 1 million claims a wek..and how many mistakes will be made. Also Drs offices make mistakes. SO there is always a huge chance its a mistake.
Second-If its not a mistake, you can fight almost EVERYTHING.
Third- Make sure YOU know whats covered. We print benefit books for people to read. If you dont read it or ask questions, they wont be symapthic to you at all. You have to call and ask a million questions about what is covered for PG . etc...because it is the patients responsibility to know, no one elses.
Sounds liek in my opinion, a mistake on someones part. So I truly wouldnt worry. If you ask questions and stay on top of things you will never have to pay anything out of your pocket, I can guarentee that.
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| Posted 1/14/06 12:49 PM |
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