Hi TuDiabetes community,
I'm hoping there are some insurance guru's on here that can help me with a question I have. So, about two months ago my Medtronic pump died and so I went through the hoops with my insurance company to find a new in-network provider so I could get an Animas pump. They sent me to Liberty Medical. I called Liberty and they got a certificate of medical necessity from my doctor and indicated that they also got prior authorization from my insurance company. They sent me the pump within a week and a half. My insurance pays 100% of Durable medical equipment.
Well, Liberty has submitted a claim to my insurance two times now. Both times my insurance wouldn't pay. When I called them today they said that they won't pay because Liberty didn't request prior authorization! It says on my explanation of benefits that I am responsible for $0.
So, what now? If Liberty did drop the ball and didn't get a PA does that they are going to try to bill me $6000 for a new pump?!!!