question regarding insurance denial and pre-authorization

Hi there,

Recently I had a procedure done as recommended by my pain management specialist at Stanford University. The procedure was a stellate ganglion block and my medical condition for which I was receiving the treatment is Trigeminal Neuralgia.

I went into this procedure thinking that Stanford had obtained pre-authorization from my insurance company. In fact, their own billing webpage had a little tool that showed my part of the procedure would be much much smaller than what my insurance company seems to have denied (20k USD!).

Stanford still haven’t gotten back to me about how much I owe (the procedure was just last week). But my insurance company shows that they have denied all 20k on the basis that its “investigational” (Codes 777 and W67).

My question is, aside trying get an appeal which is surely going to be futile (as per my previous experiences), isn’t there anything the hospital can do to help? Afterall, I went into the procedure thinking they had obtained pre-authorization and that they would have told me if the procedure wasn’t covered. Also, am i jumping the gun here since the hospital hasn’t shown anything yet?

Now, i know that I have signed papers that indicate I am responsible for paying whatever the insurance company doesn’t cover, but 20K!! I am screwed!

Thank you !