Wednesday, December 17, 2008

BAHA continued and, hopefully, concluded.

Well, that was relatively easy, though not exactly painless.

The lady at the doctor's office who handles pre-certs for surgeries called us back. It turns out that after receiving my husband's research and letter of appeal, the agent at Anthem BCBS realized that our policy is black and white on this issue. She agrees that the procedure is covered and she spent a good amount of time profusely apologizing for having been rude and sarcastic on the phone when she was rejecting our claim a week ago. Regardless of the outcome of the discussion, I think the snark was entirely unnecessary.

I would think insurance companies would require their agents to know the policies backward and forward. Regardless, the surgery is on, and by March of 2009, my Beloved will be able to hear the world in stereo again. I'm so excited.

It appears that folks are right--it is indeed the job of insurance agents to reject claims. My husband will be posting his appeal letter and his research on the subject of BAHA implants on his website in the not too distant future. When he does, I'll post a link here as well.

Please do the research if your claim is rejected. If you're paying insurance premiums, you have a right to coverage, but it's possible your agents may just be "doing their job" in hopes that you'll go away, and they won't *actually* have to do their job.

1 comment:

Anonymous said...

Hello. I was just denied insurance coverage for the Baha yesterday and am looking for any help I can get in filing my appeal. Did your husband ever post his appeal letter? If so, would you kindly direct me to it? Many thanks for any information you can share!

mermaids_417 (at) hotmail (dot) com

George MacDonald

"Home is ever so far away in the palm of your hand, and how to get there it is of no use to tell you. But you will get there; you must get there; you have to get there. Everybody who is not at home, has to go home."

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