Approved, Denied, We Were Only Kidding

somarco

GA Medicare Expert
5000 Post Club
36,729
Atlanta
Morales-Ferrer’s insurance company was refusing to pay for the same infusion medication, Rituxan, that it had covered during her first bout of FSGS, one that her doctor credited with sending her disease into remission for years. She wrangled with them for weeks, facing down three separate denials, one of which forced her to cancel an important infusion. Her story offers a window into the confounding, seemingly irrational world of insurance coverage, one that’s given rise to a network of billing gurus dedicated to helping patients fight denials.

[EXTERNAL LINK] - Same patient, same drug, same insurer — coverage denied
 
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