Medical Insurance Unexpected Coverage

I recently checked on surgical procedure and was told by my medical insurance customer service the procedure would not be covered by my insurance policy.   To note, I only described the procedure and did not submit a CPT code.

I decided to do the surgical procedure, which was medical and not cosmetic, to have the issue corrected.  The provider then submitted to cost to my insurance company right after procedure.   After a month, the insurance company approved the claim and paid for the procedure.  Woohoo!

Lesson learned: 

• Medical insurance claims can be very complex, to the point that some customer service representatives may not give an accurate answer.
• If the provider accepts insurance, always have them submit a claim for payment.

I may need this procedure again in the future. I will definitely use the same provider so that a claim is submit which my medical insurance will cover.

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This is not financial, medical, nor health insurance advice. Please consult a professional advisor.

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