Ask Me Help Desk - Insurance won't pay for medical

I live in WA state. I was not at fault rear-ended and hit the car in front of me. My car insurance has been paying the medical bills for related problems. I began seeing a doctor for arm pain after the accident and have been getting treatment for car-accident and not-car accident related problems.

The insurance agency has been refusing to pay medical bills and saying that they are related to the car accident. For one set of appointments, they asked for chart notes, they paid for my appointments, then retracted payment for a few appointments. They did not have the chart notes for those days. After they got chart notes they needed a letter from the doctor. I got a call today, they say the letter does not contain what they need. It is almost 7 months from the time of the first appointment and the doctor's office has sent me another bill. My doctor hates to deal with insurance and I do not want to call her to ask her for a letter again. The last time I got an awful message like other patients have immediate needs and she'll write a letter when she has time for it. It took a month for her to write a letter. What can I do? What should I be doing?

If you expect the insurance agency to pay these bills you have to prove them with the documentation they are demanding. There is no way around that.

Had to spread the rep Judy, but I agree completely!

If you received treatment for anything that is not part of the accident they will not pay for those visits.

I had a similar situation. What I did was demanded my dictation and medical records from every visit, it's mandantory that they give that to you. Then I mailed those records to my blue cross. If your two injuries are totally different it wouldn't be to hard for the insurance company to figure that out. However if you have arm pain from an accident and have had carpel tunnel or something before in your arms then something like that would be a good reason they are refusing to pay. But request all your medical records. They have to give you those. They store them in medical records department of course. And sometimes it goes to a different department then the doctors office but not always. And if your arm is bad enough, you can sue the other parties insurance company for pain and suffering if you got an attorney. I had arm pain for years from a car accident and I just recently found out on January 7th of this year that it was related to a disk herniation that happened in my accident that I wasn't aware of. Because I went in the hospital crying about arm pain and felt nothing in my neck. Later on I started getting stiff shoulders all the time and just figured I needed a new mattress. Well I ended up getting 2.4 million dollar settlement for that injury because I ended up having to have a disk replacement for my arm pain.

Quote:

Originally Posted by mmolina25

I had a simular situation. What I did was demanded my dictation and medical records from every visit, it's mandantory that they give that to you. Then I mailed those records to my blue cross. If your two injuries are totally different it wouldnt be to hard for the insurance company to figure that out. However if you have arm pain from an accident and have had carpel tunnel or something before in your arms then something like that would be a good reason they are refusing to pay. but request all your medical records. They have to give you those. They store them in medical records department of course. and sometimes it goes to a different department then the doctors office but not always. And if your arm is bad enough, you can sue the other parties insurance company for pain and suffering if you got an attorney. I had arm pain for years from a car accident and I just recently found out on January 7th of this year that it was related to a disk herniation that happened in my accident that i wasnt aware of. Because i went in the hospital cryin about arm pain and felt nothing in my neck. later on i started getting stiff shoulders all the time and just figured i needed a new mattress. Well I ended up getting 2.4 million dollar settlement for that injury because i ended up having to have a disk replacement for my arm pain.

DISK replacement in my neck that is...