We knew ahead of time that they were going to come in low, but they told us that of course we had the right to appeal afterwards, but knowing what to fight with is the battle so anyone out there that did appeal and won let us know what you went into battle with. Now with paying the $4,000 up front with most insurance companies once you've paid the 4 grand out of pocket expense they then have to kick in 100% not 80% which they would have since we went out of state. They now have to pay everything at the 100% level so anymore testing, etc. I have to get in before the end of the year or I have to start all over again Jan. 1st with the 80% again. If this being your case, I would almost want to wait until January so that you will have the rest of the year in case you need any further testing, or heaven forbid, another operation or something. Please check that out. My prayers are with you.
Helen C.
At Mon, 16 Oct 2000, Kathy L. wrote:
>
>I am tentatively going to Scranton in November.
>My insurance agreed to pay at the low level
>since it is out of network. I have filed an
>appeal letter asking them to pay at the higher
>level.
>
>Any suggestions to help me with my appeals
>is appreciated.
>
>--
>Kathy L.
>
-- Helen Chalmers