cbo111
Full time employment: Posting here.
- Joined
- May 20, 2014
- Messages
- 979
We are battling Anthem BC to authorize a heart-monitor loop for my DW. For the past couple months, her pulse goes from 50 to 200 when she is just sitting around, walking, or riding a bike. It leaves her with a headache and feeling nauseous. She wore a monitoring harness for a week and now the cardiologist wants to place a loop to find out what is going on and hopefully treat this. Yesterday, Anthem denied this loop procedure. My question is how to determine what dollar amount Anthem would pay the cardiologist if they did authorize this loop? I could then use this number to negotiate an out-of-pocket payment to the physician. I've never done this type of negotiation before with a physician and need some guidance. Thanks for any inputs.