Anthem won’t give pre-certification because pre-certification isn’t required on a 9k wheelchair part
This is sort of a confusing title but basically the problem is I need a wheelchair joystick attachment that turns my manual wheelchair into a power chair. It costs around 9k.
Anthem says that pre certification is not required so they won’t give me pre-approval. So I have to actually buy the wheelchair part and then hope that anthem decides to pay after I’ve already committed to paying $9,000. They could decide to pay partial or they could decide to pay nothing(I am almost at my max out of pocket as well so it may even be covered fully) but I won’t know until after I’ve already committed to buying it. If Anthem decides to deny the claim then I am out $9,000. That’s a $9,000 gamble. Is there any way to avoid this?
I spoke to an anthem rep and she recommended the wheelchair part dealer calls and speaks to the “utilization management” department to see if pre-certification could be done. My wheelchair part dealer says he spoke to utilization management with no luck. Is there anything I can do on my end? My parents keep telling me that “there is no way anthem can do that” and “that sounds illegal/not fair” but this is America and I don’t really expect for profit insurance companies to do anything fair so I figure I’m just in tough position and need to get over it so I want to know all of my options. Thank you in advance for the advice.