I just got my second EOB from my insurance company denying payment for surgery.  26K+

The first time, I called my insurance and they explained that the day of surgery someone was supposed to call them and get an "intake" approval so everything that happened in the hospital that day would be covered.  This is in addition to having appoval for surgery. 

So, I called my surgeons insurance coordinator and she says she has everything documented, who they talked to, etc., and they got the "intake" approved.  She says they will rebill.

And now they are STILL not paying after the rebill. 

Getting a little worried.  Do I even have to say that I pretty much HATE my insurance company about now?  I am ready to make some phone calls to an attorney.  Maybe even the state attorney general.  This is ridiculous.  I have the approval letter for surgery.  Nowhere in that letter does it state "call the day of surgery to get your "intake" approved".  WTF?!Apparently, someone DID call, and they are still not happy. 

Just keep at it and don't send them any money. Photocopy every single document you have and fax it, email it, and send it registered mail. Good luck.

 O am so sorry this is happening to you. read your insurance coverage. It may state it in there that you have to call. I know that it is stated in mine that I call. 

My insurance company is doing the same thing, and I am almost four months out. I am not worried about it, because my doctors office says they will play this game for six months tops and then they will pay. I just call them back when they say I have to; and answer their questions - so far about other insurance coverage, yada yada yada.

The "intake approval" with the insurance company is done by the hospital, not the patient. If they failed to get it, you are not responsible for the bill. Their error, their problem.

 

 My insurance company is also refusing to pay. The hospital said just because they got a pre certification doesn't mean the insurance company has to pay.  I just got the final bill from the hospital today and when I called the billing department they gave me the choice of $55,000 in payments or $12,000 cash payment.