Tag Archives: claim appeals

Extra lab tests likely to be covered, after deductible

Do insurance companies cover the cost of more accurate tests, such as ultrasound or blood tests, if a patient can provide evidence that he/she has one or more cancer marker genes? Informed Patient Dear Informed Patient, The insurer will pay for medically necessary tests.  So, if the doctor believes that the ultrasound or blood test […]

Affordable Care Act: Not all colonoscopies are “preventive”

I would like to see you do research and topic of colonoscopy on patients that have been diagnosed with ulcerative colitis previously.  Getting insurances to cover for these people is not good.  They have to pay their high deductibles,(mine is $2500)therefore really is not affordable for most. Insurances feel that colonoscopies are diagnostic not preventive […]

Affordable Care: Hassles over pre-existing conditions will stop

“I have a pending claim with my insurance company. They’re delaying paying the receiver to do a “Claim and Eligibility Review”. What should I do? In a letter, they’d like to review my medical history from a few years ago, and would like me to authorize access. They place this caveat: “under no obligation to […]

When dental care is covered by the health plan

My one-year-old daughter was diagnosed with dentinogenesis imperfecta; her teeth will be weak, soft, and discolored.  Treatment will have to be done for her baby teeth and her adult teeth.  We don’t have a dental plan.  Is it possible that our medical plan would pay for this? Thin Smile Dear Thin Smile, Yes, it is […]