Denied Coverage for Medically Necessary Test – Still Waiting on Patient Bill

I recently had a vaginal swab PCR test at a large hospital clinic, and my insurance denied coverage, labeling it as “investigational/non-covered,” even though the test was medically necessary. Interestingly, the hospital’s patient portal still shows $0 patient responsibility while the claim is pending. The denial appears to stem from a change in medical policy that now classifies this test as investigational. Premera confirmed that in-network providers aren’t required to write off the charges, so patients could potentially be responsible. Since the hospital hasn’t posted a patient responsibility amount yet, I’m curious how they usually handle claims like this. Has anyone else experienced something similar, and how was it resolved?

https://ift.tt/6lJih5N Submitted September 02, 2025 at 12:34AM by LemonDrop789 https://ift.tt/2U50BRx