Insurance Battle

We switched insurance companies on the first of the year to Brian's new plan, a much cheaper, better coverage plan. (So we thought.)

I got a call from the Medical Supply Company a few weeks back because they received a denial from the insurance company - they had billed my policy, which termed 12/31/10. I explained how I placed the order for Kara's Neocate in December, so I assumed it would be billed under my plan. This was going to work perfect because we met our out of pocket max for the year. I explained this to the gal I spoke with and she said they bill it out on the delivery date which was January 3rd. BIG BUMMER, but we'll deal with it. She was going to do some looking into this to see if they could change anything but then never got back to me.

Today, we were opening up yesterdays mail and we received some explanations of benefits from the claims we've already had this year. In this was a denial. A denial for $2,162.00, the monthly cost of Kara's Neocate. The reason? Non-covered benefit.

I think I've got my work cut out for me. I don't necessarily remember the details of my battles last summer, all I know is that it SUCKED. I did get it paid for eventually, but to have to do this again is not going to be fun, and, it's not like I have anything better to do, right?

We have all eight cases of formula still boxed up. If worse comes to worse, we'll have to return it (hoping they'll take the unopened cases back!) and try try try to get her on a well rounded diet so she won't need the Neocate. For now though, it's a staple in her diet. I'm already overwhelmed.