How do I get insurance to pay out of network surgeon full costs? 1 Answers as of February 27, 2011

Patient had operation with out of network provider after being mislead by surgeon's office after insurance gave pre-approval. Now, insurance only paid 4.7% of actual costs submitted by surgeon.

Ask a Local Attorney. 100% Anonymous. Free Answers.

Free Case Evaluation by a Local Lawyer: Click here
Cody and Gonillo, LLP
Cody and Gonillo, LLP | Christine Gonilla
Sounds like you will have to file an appeal of the coverage determination. Take a look at the Explanation of Benefits Statement. On the back there is usually information on how to exercise your appeal rights and within what time frame you have to do so. Good luck.
Answer Applies to: Connecticut
Replied: 2/27/2011
Click to View More Answers: