Will my insurance cover this?
Now, this is a question we deal with on an hourly basis. And it’s unfair, but the honest answer is “most likely, but we don’t know for sure.”
Each Case is Different
And it’s NOT for lack of checking and verifying your benefits. We do that from the very first phone call. And it’s not because we’re too lazy to check and talk with a representative from your insurance. We do that from the beginning as well. The amount of time that Bella spends with the insurance companies is incredible. And we move mountains to make sure we are accurate with the ESTIMATE we present to you regarding how much your insurance is expected to give as a benefit.
The reality is that until we submit a claim to the insurance, we don’t know I they will cover things or not. Even if they say it’s a covered benefit, sometimes they don’t…there’s a lot of fine print not disclosed to us…and thus we don’t know to disclose it to you. And even with the “pre-authorization” insurance companies recommend you do for anything over 100$, the VERY first sentence at the beginning of those “pre-authorization” we get back is “This is not a guarantee of benefits paid”. And sometimes, the insurance companies will return a blanket “not a benefit / no coverage” letter just to see if they can get away with it.
I hate insurance companies. They have not changed their "maximum yearly benefits" of 1000-1500$ since they started back 40-50 years ago...seriously! But we work with them out of benefit for our patients. And we know them like no one else.
Dr. Kim's Recommendations in 91207
So what is a patient to do? Well, the best that you can do is go to an office that has a 98% accurate success rate of knowing what the insurance will or will not cover. Go to an office that will at least let you know the possibility of things not being covered and the worst case scenario so that financial surprises are minimized. Go to an office that knows the ins and outs of most all the PPO insurances out there like Bella knows. And be at an office that will help you and work with you should the insurance companies try to pull a fast one and not cover things that we know they should. Dr. Kim’s is that office.