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[IP] Preexisting Denial?!
I came home this afternoon to find a very disturbing letter from my
insurance company, which is based in Dallas, TX. It acknowledged having
received a claim from my endo for a prior visit, and then goes on to say
they must determine whether or not my condition is pre-existing before they
can process the claim. Several questions are asked in this letter, one
being whether I was treated for this condition from 10/1/98 to present (?).
The final paragraph states, "If a condition is determined to be pre-existing
and benefits have been paid, a refund will be requested for the amounts
paid. Please let your employer know if you have creditable coverage."
My employer signed on with this company earlier this year. My employer knew
I was diabetic when going into business with this company and in fact, I had
several meetings with Benefits to be sure that my endo was included in the
list of approved doctors that the company was offering us. We were also
assured in meetings that diabetic supplies and such would be covered (even
though Texas has already passed a law making that mandatory.....). To date
the insurance company has approved all the claims I've filed with little or
no trouble. If they were to request a refund at this point it would run
into quite a bit of money (almost a year's worth of treatment).
As I said above, I just got this letter this afternoon, so I haven't had
time to talk to anyone about it....will be doing that tomorrow. Hopefully,
this is just a mistake, but I have already called the Texas Insurance
Commission to request a formal complaint form. I just needed to vent right
now as I am pretty anxiety-ridden about all of this. I just got on the
insulin pump this year and I'm not about to be taken off it without a fight.
BTW, the pump was covered by a prior insurer, so the equipment itself
would not be a matter of contention with this carrier.
Thanks for listening........ :)
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