Prior Authorization Form Limbo

Help! I got a few MRIs a year ago and was billed the full cost ($8000) by my insurance company, even though my insurance assured me before the scans that they cover MRIs up to 60%.

I’ve been calling my insurance company and the hospital for a year trying to figure out why this happened and finally got the the bottom of it – no prior authorization form was sent to my insurance company. I had never even heard of prior auth and had to do some research, but once I became more knowledgeable I began calling the hospital to figure out who’s responsible. My primary care provider who ordered and analyzed the scans is telling me that it’s the radiology department’s fault, but when I call the radiology department they tell me the MRI company is a separate entity and I need to speak to them. Only to be sent back to my primary care provider again.

Please help me understand who is responsible so I can get to the bottom of this. I cannot afford an $8k medical bill!

submitted by /u/filmandtv1000
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