" Fair Hearing Trial "

[Journeyman]

I've been a Franktalk member for almost 2 years . One topic I've seen repeatedly come up, from exasperated members, is their insurance being denied . Fast forward to today.... I was just scrolling IG and came across a post talking about exactly this problem- Insurance denying medical treatments . The title of this post was her answer . Tell the insurance company you're gonna file for a " Fair hearing trial " ( Google it ). She claims that sometimes just uttering these words will get the insurance company to offer you an appeal . She said tell them " No thank you because if your judgment was any good , we wouldn't be in this situation. " . Anyway this will force the insurance company to attend a trial to present evidence to defend their denial in front of an impartial 3rd party . You will also be able to present evidence, along with your Doctor, of what steps have been taken and why your claim should be approved. This is the first time I've ever heard of this but I was sure to save the video. I had my own insurance problems until Dr. Clavell intervened with a " Peer to Peer" review with a Dr. representing the insurance company. My surgery was finally approved but I was getting pretty nervous about it . I don't know if this will help any of the brothers out there but it's worth a try if everything else fails .

[Friday121224]

Thanks Journeyman, I am in over my head looking for ways to have my insurance to cover at least part of my revision. I have Aetna. Don’t have Aetna for implant or if you need a revision. I plan on switching companies during open enrollment in the spring.

I will keep a “fair hearing trial” in my back pocket for sure. Appreciate the tip!!

[Journeyman]

Yw .... ED is traumatic enough. I fucking hate these crooked insurance companies constantly taking your $ and when you finally need them , they find some loophole to deny you coverage on a procedure that is medically necessary.

[splitpeach]

My god... Moments like this make me so happy I'm in the UK and can use the NHS.

Its slow, theres no whistles and bells and devices may be more limited (not really though) but if you need the treatment you get it. And all totally free from world class surgeons (esp if in London)

Maybe the day will come when the US gets a public health service like Europe. Then it'll be the true land of plenty.

[Implant2025]

I recently retired as an oncology nurse. The docs on my service spent an incredible amount of their time fighting with insurance companies to get the best chemo, tests and surgical procedures approved for our patients. Insurance companies are the Anti-Christ.

[Journeyman]

Here's the article ( responding to Carboburrito's post )