this is an update from the below previously posted posting in a prior post.
well, i finally got all my reports sent in, even the chinese ones. the insurer
wanted to have their own translation done, which makes sense.
several weeks later, i get two messages:
1) the translated documents have been reviewed and claim denied.
the documents were echo reports showing that i was stable. of course,
the explanation that the reports were in error meant nothing. i explained
that the chinese report showed an eva of 2.0, while the angiogram in
india showed the eva actually at 0.6
i requested a copy of the translation, but they refuse, claiming it is an
internal document. my question is was the translation correct, and did it
agree with my own translation? and my next question....what does it
matter, since the only report that is used in determination for surgery
was the angiogram?
2) coverage is only provided when more than 100 miles from home.
like, dude. i'm in southeast asia. that's about as far as you can get
from home in texas without entering an alternate universe.
so....calling lisa in katy. where do i go from here?
current insurance is pretty worthless, especially now that the provider
switched from an australian to an american carrier. i went ahead and put
in a claim for january's avr.....not really expecting to have anything
covered, just who knows, maybe they might reimburse a small percentage.
going as expected, everything is denied. but the reasons seem to be
pulled out of their....elbows. have sent several emails questioning the
denial, each time the service rep chooses another exclusion at random.
but then each time i explain why that exclusion doesn't apply, they
have a different rep respond with another arbitrary exclusion. it's like
they don't bother to read anything i send...at least no more that the first
couple words, which allows them to select a boiler-plate denial message.
i understand it's their job to deny claims, and the more ignorant they
seem, the easier it is. i'm sure most people just give up after a while,
and that's what they're hoping for.
well, i finally got all my reports sent in, even the chinese ones. the insurer
wanted to have their own translation done, which makes sense.
several weeks later, i get two messages:
1) the translated documents have been reviewed and claim denied.
the documents were echo reports showing that i was stable. of course,
the explanation that the reports were in error meant nothing. i explained
that the chinese report showed an eva of 2.0, while the angiogram in
india showed the eva actually at 0.6
i requested a copy of the translation, but they refuse, claiming it is an
internal document. my question is was the translation correct, and did it
agree with my own translation? and my next question....what does it
matter, since the only report that is used in determination for surgery
was the angiogram?
2) coverage is only provided when more than 100 miles from home.
like, dude. i'm in southeast asia. that's about as far as you can get
from home in texas without entering an alternate universe.
so....calling lisa in katy. where do i go from here?