What You Can Do When Your Health Insurance Denies Your Claim

Recently I got a hefty bill from a radiology department associated with the hospital I went to in not one, but two emergency situations. There is good reason for both visits and even more so good reason for the procedures that were performed. Regardless of how important I was told these procedures were I was still denied coverage for them by my insurance company. The reasons were #1 "these services were not medically necessary", and #2 was "these services were for a pre-existing condition". The statement that one of the procedures was deemed not medically necessary is outrageous. To make my point valid I will go into a detailed explanation as to what exactly happened on both these occasions.

On June 4^th 2007 I was pregnant with a high risk pregnancy. I woke up on the morning of the 4^th due to severe cramping and bleeding. My husband rushed me to the emergency room. This was my 5^th pregnancy and it was about to be my 5^th miscarriage.

A week prior I was diagnosed with not one, but two different blood clotting disorders. The first was an elevated factor 8, and the second was a disorder known as P.A. 1 positive. I was familiar with factor 8, but had never heard of P.A. 1 positive. It was with good reason that I never heard of the second disorder. It is a newly discovered condition in which scientists have only been familiar with for about 2 years. It's so new that doctors have a hard time explaining what the condition really is. All they really can tell you is that it is a type of blood clotting disorder and it has the potential to terminate a pregnancy.

With the knowledge that I had two blood clotting disorders my Gynecologist immediately put me on heparin. Heparin is an injectable medication. Most people think that heparin is a blood thinner, but really it is an anticoagulant. Which means it's breaking up blood clots for you because your body can't do it.