I have more questions… Sorry! Btw I did remove some of the personal information from my previous post. I don’t have anything to hide but probably best to avoid details.
My first question is about requesting clarification and clear definitions of terms used by the insurance company that are ridiculously vague, broad and meaningless.
I sent them a follow up email after faxing the latest medical documents they requested and added a brief message with specific questions about terminology in a letter they sent me. (I always fax and email the documents myself, which is good because I caught an error in the initial questionnaire : an entire page was missing. I also want to know what my doctor is providing and what the insurer is requesting!)
Do you think they will answer? Can I insist if they won’t provide the info? How can I or my doctor answer when the question isn’t clear? I asked for definition and examples. It seems like a reasonable request.
How would I go about submitting a claim in order to be reimbursed for the doctor’s fees I had to pay? Directly to the case worker (email) or through my health benefits insurance claims?
I had to pay twice within less than 2 months and the latest request resulted in about at most 10% new information. They literally asked the same questions that my doctor already answered in the initial questionnaire and the file notes were the same ones previously provided with the addition of maybe 5 pages.
This is so frustrating. I can’t believe we have to go through this process.