Day 4,034 – Insurance Challenges

The administrative challenges continue…

On Tuesday, UCLA called to confirm my PSMA PET scan next week and, during the call, the said that they had not yet heard from my health insurance company as to whether or not they would cover the cost of the scan. She asked if I wanted to proceed next week, paying the $3,300 myself, or delay until the insurance was settled. If I delayed, the next available appointment would be in February 2022.

I told her to keep next week’s appointment and that I would battle it out with the insurance company after the fact.

On Wednesday, UCLA calls saying that my insurance had denied the request for the scan and wouldn’t cover the cost. Again, I reiterated that I would keep the appointment and pay the cost myself.

But I was curious about the reason for my denial, as I had an email from my health insurance company earlier in the year indicating the values that they would pay for each of the CPT codes that were given for the scan, so I emailed them again (after trying to get through on the phone on the day before Thanksgiving failed).

I was actually surprised that I received a response this morning that read:

I accessed your account and I see that the pre-approval was denied because of insufficient medical records was [sic] provided from the provider. I request you to please ask the provider to call…and verify the documents needed to submit for prior authorization then send the documents so that we can approve it.

Of course, UCLA is closed for the holiday weekend today, and I’ll have to just try to get them to get this taken care of on Monday when I go up there.

It’s always something.

Be well.

2 thoughts on “Day 4,034 – Insurance Challenges

  1. Lori

    Oh MY!
    This shouldn’t be this difficult! You’ve had administrative obstacles…one after another! It is very sad. Most people are not as savy as you with follow through. Many people would give up and/or not be able to afford the test. My blood is boiling! I’m sorry you have this added stress that you DO NOT need! Keep us posted!

    Liked by 1 person

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