Claim Denied, So Confused
I had one kind of Kaiser insurance up until 7/31, and then that ended and my new Kaiser (slightly different) insurance began 8/1.
On my old Kaiser insurance, I had the benefit of 12 sessions per year of massage therapy, and that benefit renewed on 7/1.
My new Kaiser insurance does not have the benefit.
In the month of July, I has 5 massage therapy appointments for neck and shoulder pain. 4 out of 5 of these appointments were covered, but the 5th appointment, on 7/31, was denied. The claim message reads: “Benefit maximum for this time period or insurance has been reached. (DENY – 119 – Patient Responsibility.)”
My best guess is either they think my insurance ended on 7/31 or the claim got processed on 8/1, OR for some reason and not written anywhere is that I was only allowed 4 sessions a month, not 5.
Is this worth appealing? I’m in the middle of a move and mourning the passing of my mom. I can afford to pay the 200 for the session, but I’d rather not. But I also have heard the appeal process sucks ass.
While Kaiser has been annoying in the past, they’ve never made mistakes in my 5 years with them so I don’t want to put time into something that is just a waste of my time.
