UHC Claim Denial
Does anyone have any experience with the following claim code?
"Benefits for this service or supply are denied. Your plan only covers proven procedures. This service or supply is considered unproven for the diagnosis code billed. For consideration of coverage, you or your health care professional must submit scientific evidence that shows this service is safe and effective for this diagnosis. A network health care professional may not bill you unless you gave written permission before you received the service or supply. (PE)"
I had mohs surgery in November to remove melanoma and basil cell carcinoma. I just got a claim denial for the date of my surgery that falls under "laboratory services". I'm assuming this is for the biopsy of what was removed because it is from some biosciences company. All other claims regarding my surgery and my surgeon specifically have been approved. Obviously I have calls to make, but I was wondering if anyone has resolved the above code, and how so.
submitted by /u/bronzekite
[comments]