Can a health insurance company deny benefits after pre-approving and allowing the patient to proceed with surgery?

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Can a health insurance company deny benefits after pre-approving and allowing the patient to proceed with surgery?

I was pre-approved and under went weightloss surgery, I am now being told this was an exclusion on my policy after the fact. Can they do this after allowing me to go through with everything by granting me reffereals, and pre-auths. Should they have know I was not eligible for this service and denied it?

Asked on May 20, 2009 under Insurance Law, Pennsylvania

Answers:

FreeAdvice Contributing Attorney / FreeAdvice Contributing Attorney

Answered 12 years ago | Contributor

This happens all the time. Appeal it, and fight for the payment.


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