aftet dealing with workers comp (aka gov run insurance co–well it was–now it is quasi gov run) and Social Security (gov run ins) for 20 + years due to my husbands on-the-job injury–the horror sotries make pump and CGMS denials pale—but the end story is the same. Insurance companies make it as hard as they can to make you give up.
Learn your policy. Keep a log–names dates and times of everyone you talk to, everything you mial and the cert#'s and return receipt stubs. Keep fax confimraitons and mail everything certified mail that is important. When doing so make sure each piece of paper that you encolse in the certified mail has the certified mail # on it–this is an important step.
Don’t give up…the more times you appeal–the less daunting itis and the less they mess with you.
Find out ahead of time how your state insurance commission/governance works, how to report the insurance companies to them for harrassment and non-compliance–and then do it. At the very least normally the larger the # of complaints the more it hurts the insurance companies bond rating…some states even fine insurance companies for doing wrong and give the $$ less the admin fee to the insuree. Most people never bother to check–it is a pain…but if more people did it it would help cure the deny everything first policy of most insurance companies.