HEALTH INSURANCE POLICY STATES THAT FOR CT SERVICES “THEY MUST BE PERFORMED AT BLANK FACILITY, HOWEVER BLANK WAS SOLD!

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HEALTH INSURANCE POLICY STATES THAT FOR CT SERVICES “THEY MUST BE PERFORMED AT BLANK FACILITY, HOWEVER BLANK WAS SOLD!

IS THE INSURANCE COMPANY LIABLE TO PAY CLAIM WHEN CT SERVICE IS PERFORMED AT ANOTHER FACILITY?

Asked on May 29, 2009 under Insurance Law, Idaho

Answers:

L.M., Member, California Bar / FreeAdvice Contributing Attorney

Answered 15 years ago | Contributor

Possibly.  It depends on the wording of the policy.  Sometimes there is more than one in-network facility.  And you also need to determine if the policy pays for services at an out-of-network facility.  If it does, it is likely at a lesser rate.  It's always a good idea to contact the insurance company before any test or procedure if there are questions regarding whether or not a particular service provider is in their network.


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