conversation: User (liarliarplants4hire): "tl;dr - hurt leg with ax at 6pm. UTC centers closed. Went to ER. 6 stitches and tetanus shot. Denied as "emergency room setting not medically necessary". Sent snarky letter with pictures. Still denied. Met deductible.\n\nOn 9/29/16 ~6pm I hit my ankle with an ax and had a nasty laceration. Neighbor drove while I called local UTC to see if they'd stitch it up for me. No docs were there. APN's only; no stitches. Off to the ER. Cleaned, sutured, dressed, out the door. Anthem BCBS denied the two claims sent - both ~$1100 each. One from ER and other from a "Primary Care", even though only one nurse cleaned me up and only one doc sutured.\n\nAll claim denials are to be rebutted in writing. I sent a letter with pictures of the ax and my wound (before, during, and after suturing). Still denied. I've requested the ER re-code their claim to more accurately reflect the emergent nature of the visit, but everything looked pretty correct on their submission (not sure when / where the primary care submitted or where that came from). I think $2200 for 6 stitches is a bit high...\n\nSo, now what? It looks like I'll have to try to whittle away at this and go through arbitration. Any luck with that?"
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