Insurance denied claims, stating pre-existing condition. But it’s NOT! How do I appeal/fight back?

Alexandria T asked:


I went in for an urgent care visit back in October bc I had a UTI. My insurance co refuses to pay the bill, stating that its a pre-existing condition. I.e., I had one less than a year ago and was prescribed antibiotics for it.

However, an infection IS NOT pre-existing unless it is chronic. Furthermore, the UTI in October is technically a NEW infection, as the previous one was treated and “cured” with antibiotics. Hence, the infection cannot be termed pre-existing as it is neither the same infection from before (though yes, the same type - both UTIs) nor is it a chronic condition.

Is there anything I can do to appeal aside from sending a doctor’s note in my favor? I cannot afford to seek out a lawyer for this unfortunately. What can I seek on my own? Any legal cases I can review? Any other documents or letters I could write to help my case?

Thank you in advance

Berta