Health Insurance Bureaucracy (Medical Directors) Advice Needed

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I am a provider in California and I seem to have pissed off a new medical director at a local insurance (it’s a Medi-Cal Managed Care Health Plan). They are terminating my contract because a medical director and I had a disagreement on their new utilization guidelines in a meeting I had requested to get clarification. I haven’t violated the contract or had any patient complaints filed against me. They simply state that it was a business decision, even though I complied with the changes.

Any suggestions or advice on how to get a meeting with their medical directors to work it out?

Any agency I can contact at the state level? (They are a Managed Care Health Plan under the Department of Healthcare Services)

So far I have:

– Sent a letter to their “higher ups”, and they said “no thanks”

– Asked for a meeting with the director I had the argument with, he said “no thanks”

– I have contacted the ​Department of Health Care Services Office of the Ombudsman to see if they can step in and mediate a meeting, but no guarantee if they’ll take up cause.

submitted by /u/drprime3000
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I am a provider in California and I seem to have pissed off a new medical director at a local insurance (it’s a Medi-Cal Managed Care Health Plan). They are terminating my contract because a medical director and I had a disagreement on their new utilization guidelines in a meeting I had requested to get clarification. I haven’t violated the contract or had any patient complaints filed against me. They simply state that it was a business decision, even though I complied with the changes. Any suggestions or advice on how to get a meeting with their medical directors to work it out? Any agency I can contact at the state level? (They are a Managed Care Health Plan under the Department of Healthcare Services) So far I have: – Sent a letter to their “higher ups”, and they said “no thanks” – Asked for a meeting with the director I had the argument with, he said “no thanks” – I have contacted the ​Department of Health Care Services Office of the Ombudsman to see if they can step in and mediate a meeting, but no guarantee if they’ll take up cause.
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