r/HealthInsurance • u/Tough_Cauliflower767 • Apr 11 '25
Claims/Providers 96k bill not covered
My wife and I are seeing a fertility doctor. The MD was adamant my wife needed surgery to clean out the fibroids and polyps in her uterus to improve conception. Prior to surgery, i confirmed over the phone that this was covered by my insurance. The fertility clinic said it's covered beside a $400 anesthiesia fee and good to go. Post surgery I got a bill for $3500 because apparently not everytning was covered. I reached out to the clinic and they don't know why it was denied. I sent an appeal to bluecross after that. Just got a notice in the mail that the appeal was denied and we owe 96k!?!?
It's after hours but I will follow up with them tomorrow. Praying this is a mistake. I feel like this is a he said she said with the insurance coverage. How can they tell me it's covered and then send me bills. Am I liable. Who os at fault.
Thank you
2
u/NoKale528 Apr 11 '25
I know it’s just dental, but we can literally get a pre-authorization a person’s name do the treatment plan. Everything’s great send it in and they deny it and there’s nothing you can do about it.