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Re: [IP] insurance "in writing" quetion-venting too

>.. An example:
> On Shane's last eye surgery, one of the codes submitted was for
> treatment of a "retinal lesion". The insurance paid 50%. They told
> us, it is our policy to always pay only 50% for that code. Is this
> mentioned anywhere in our policy? NO! And we have read the policy
> (including fine print) several times. I am particularly frustrated
> with their refusal to pay several items on this last eye surgery,
> because up until that point they had been great about paying
> absolutely everything submitted (including 100% of pump and
> supplies).

You want to reverse the situation here.... appeal the refusal to pay 
and make them show you where the policy says IN WRITING that they are 
obligated to pay only 50%. Continue to escalate the matter to the 
state insurance commissioners office if necessary. Many insurers 
refuse to pay for things knowing that many consumers will simply 
accept their decision as gospel. Not so!! It's your money they are 
messing with, get the bill paid.

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