Can an insurance company approve a procedure and then deny it after it has already been performed?

Question Details:

Our insurer gave my son's oral surgeon the OK to remove his wisdom teeth. They even paid for the consultation fee. When the doctor's office billed them after the procedure, our insurance company said that it was not covered. I am now stuck with a bill for $2186.50. The insurer has a recorded message when the service rep told the doctor's office that procedure was covered. The paperwork has been resubmitted. I am waiting on a final decision. In the event that it is denied, do I have any legal options?

Asked on 8/9/2011 under: Insurance Law Massachusetts More Legal Topics ▼All States ▼