Insurance refuses Chemoembolization- help!

concernedcaregiver....bless your heart your mom is lucky to have you. Unfortunately you have to constantly do battle with the insurance companies because experimental seems to be the buzz word they use to deny coverage. I have learned that sometimes it comes down to coding. I have had my dr resubmit a claim and when he recoded it they paid it. Not sure about the treatment you are describing but I would talk to the insurance people at the drs office. They are familiar with how to get a claim paid and they can explain the pitfalls when dealing with the insurance company. Bottom line for them is they dont care where the money comes from just that they get paid. Many people have won appeals with insurance companies. Be persistent. I just had a claim denied for an oncotype test that the insurance approved ahead of time and now are denying it. Makes no sense at all. I have the lab company and the BS office appealing the denial. Regardless, I am not going to pay it because I told them on the front end I would not have the test done unless it was covered by insurance. What is the point of getting it preapproved only to be denied when it came time to pay up. None of us needs this additional grief but it is the way it is now. Good luck...keep us posted.