Approved Predetermination doesn't speed up reimbursement
by Just Me on Nov 19, 2024
1 out of 5 stars
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No clear, complete, instructions to ensure you submit everything to them that they require to process your claim in a timely manner and if they need you to re-submit the same information to them that was included in your initial predetermination request, which drags out reimbursement. They seem to give you more information with each call you make to them, inquiring on the delay. It would also be helpful if they included the details of your coverage for that item, in the predetermination response, e.g. Up to $150 coverage once every year. They do not send updates as to the status of your claim, you must sign in daily to see if it is still pending or not, and no added info is added there... their system can cause financial hardship if you are relying on a quick reimbursement... Much easier to deal with a company who pays the service provider directly. Benefit coverage should improve more, annually, to keep up with the always increasing high fees charged by service providers for services required.