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Medical Coverage Denial

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in 1998 i injured my neck and for my injury i received out of network treatment for roughly 3 months. aside from my co-pays and deductibles my Health insurance covered all treatments. i re-injured my neck again in 2000 and once again i received roughly 3 months of treatment. but according to my doctor's office/treatment center, my Health insurance refuses to cover $3,100.00 due to not being "reasonable and customary allowances". the treatment center claims they have tried to collect this fee on multiple occasions since december of 2000 with no luck. i have just received notice in the mail from the treatment center that since my insurance company refuses to pay and i am fully responsible for the $3,100.00 and that i have 10 days to contact them to arrange payment. when recieving this past tratment(year 2000)i recall more than a few times that i qestioned the "staff" as to whether the treatments being administered were covered and was assured that they were. also, why would essentially the same treatment be "reasonable and customary" the first time i received it and not the second time. please advise.


Senior Member
My response:

It may have something to do with Policy changes having been made between the first and second treatment intervals.

When you called your insurance company, what did they tell you ?



they just tell me that they feel the charges are not "reasonable and customary allowances".

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