My UHC dental requires pre- authorization for IN NETWORK services other than routine checkup and cleaning. I prefer that because then I don’t have to wait for the Insurance company’s decision to deny it after the services!
A couple of years ago, I was denied coverage for a very expensive procedure (over $4000) because the doctor was out of network. The problem was that he WAS in network. He said he was in network and he was listed on the Insurance company’s website as being in network. It took about six months and at least 30 calls and dozens of emails to finally get it paid. Every time I contacted them, I had to explain everything from the very beginning. As far as I could tell, no one followed up on my original complaint. At one point, they asked me to send them a screenshot of their website showing that the doctor was in network!!
Based on that experience, I ALWAYS get pre-authorization for any medical or dental procedure.
|