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PostPosted: Sat Jul 01, 2017 2:45 pm 
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Joined: Fri Dec 30, 2016 7:01 pm
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Location: Mid-Atlantic
I've since switched to a regular medical dr who prescribes. I pay $30 co-pay for a specialist visit and $25 for suboxone prescription. I was paying $200/mo at a clinic so that's what i'm trying to get reimbursed for.
I was told by highmark before I even started treatment to file a major medical claim to get reimbursed.
Well, it took them 7 months to finally get all the info they needed from me to deny the claim.
Saying "we don't cover methadone" and "those drs dont bill insurance." Um, i've never been on methadone.
I'm pissed because I had to switch drs. which has the possibility to totally derail someone's recovery!
PLUS I want my money back.
Funny thing is highmark was all to willing to reimbursed my s.o. for his pain meds dr. What hypocrites!

So are there any repercussions for appealing? I don't want them to deny paying the dr i'm going to now. Do they always deny claims at first? What should I tell them in the appeal letter?
I'm on a mission. Heads will roll!

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PostPosted: Fri Jul 07, 2017 9:30 pm 
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so, by lack of response, has no one been reimbursed by highmark?
what about other insurance companies denying claims at first?

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Fond Du Lac Psychiatry
Dr. Jeffrey Junig, M.D., Ph.D.

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