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In Reply to: will pay maybe,after surgery posted by Jim on May 01, 2003 at 10:45:00:
: My Insurance says that it will pay for the type surgery i need,but that it will not make a ruling untill after i have the surgery.
: Is this legal,to make me pay for the surgery (35,000.00)dollars and then make a ruling after the fact.In the meantime i have to come up with the money which i may or may not get back.
: thanks
Most likely your policy rquires pre-certification for this surgery,
by failing to make the decision prior to surgery, the insurance company
most likely has waived there right to deny the benefits after the
fact. They are going to check this bill very carefully. Have
your doctor's office place them on notice of his services and have
hospital place them on notice as well if they think this necessary.
Contact your Hospital's patient account representative and they will
be able to answer many of your questions.