Our second son was born this May and right after his birth, I enrolled him into my health insurance plan (an HMO in California) through my university HR website, and chose a Primary Care Physician for him. Yet, a month later, the incurance company sent us an ID card with a different doctor on it. In between, we had seen the doctor that we chose a few times and she authorized some tests for my son. So now there was a problem, because when the clinic tried to bill the insurance company, they were denied. I immediately wrote an appeal letter to the company and explained what happend. Yet, the insurance company said those tests were not authorized and we should assume the entire financial responsibility.
I am planning to re-appeal this, because we did everything that we was supposed to do. It was the insurance company that messed up. Other than direct negotiation with the HMO, how about an appeal to the BBB or the DA's Office of California? Anyone has any suggestion? Thank you very much!
I am planning to re-appeal this, because we did everything that we was supposed to do. It was the insurance company that messed up. Other than direct negotiation with the HMO, how about an appeal to the BBB or the DA's Office of California? Anyone has any suggestion? Thank you very much!
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