I am going to have spine fusion on my L4 L5 S1. The surgery is scheduled for just a few weeks but I just received a letter from my insurance saying they denied the claim. My doctor has a peer to peer on Monday. I was wondering the doctor who denied my claim (from the insurance company) is specialized in emergency medicine not in spine procedures. Is this allowed? Or does the Dr from the insurance company have to be specialized in the field of my medical request?
- By Team TDO
Every company has rules in place for allowance and rejection of claim. The rejection letter will usually mention the reason for which your claim was rejected. You can always send in your appeal back for a review. Your physician will be better placed to guide you in this regard.