Insurance says they can’t tell me what tests they will pay for until after I’ve had them
Wasn't there a law against surprise billing? How am I supposed to know what tests I'm 'allowed' to get? Conversation below.
Thank you for your e-mail on 07/05/2023. According to our records benefits are available for the codes that you have provided. There is no pre-authorization needed.
Please note: All services are subject to a medical review for medical necessity and we cannot guarantee payment.
Thank you. Can you elaborate on "All services are subject to a medical review for medical necessity and we cannot guarantee payment."?
These were ordered by a neurologist. What designates medical necessity and how am I to know if BCBS will pay?
Thank you for your e-mail on 07/05/2023. Medical Necessity is what Blue Cross deems to be reasonable, customary and Medically Necessary. Unfortunately, there is no guarantee of payment as we will not know how a claim will process until a claim is submitted by the provider.
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