LONG POST-North Carolina-My pain management doctor is with a small anesthesia company inside a large hospital system. April 24th, I got a call that my doctor was no longer in network. I immediately called my HR dept who told me to fill out a Continuation of Care (CoC). This would allow me to finish my treatment plan as an in network patient. I immediately filled it out, drove to the drs office with a post it note with that they needed to fill out and what # to fax it to. They said they would. A week later, I called United Healthcare (UHC-my insurance company) to see if they had received the CoC and they didn’t. I called the drs office to ask why they didn’t send and the woman told me that bc I had an out of network plan, I didn’t need this form. I told her I did and if she would please send the paperwork back to me and I would fax it over myself. She did and I immediately faxed it over on May 8th. I called UHC again and asked the CSR if I could explain what I thought the CoC was, I did, and the CSR agreed. The CoC is denied. I call UHC to ask why and they stated that I had 30 days from the day I was considered out of network, which would have been April 1st. I immediately call the drs office and let them know what’s going on. That they were supposed to inform me April 1, not April 24, and that because the Continuation of Care wasn’t faxed within 30 days, I was denied. I was connected to a supervisor at the drs office who told me that again, I didn’t need a CoC bc I had an out of network plan. I yelled at her said that someone was lying and I’m damn sure it’s not UHC. She said she would contact UHC and call me back. She called back and admitted their office was wrong. I filed another appeal-denied. UHC tells me that the dr office has to file it. The drs office fills out the appeal, and said it would take up to 30 days. This was in July. I have been emailing every month since then asking for an update. They said they still have not heard any result. On Jan 10th, I got a bill for $22,442.65. I emailed the drs office contact, the supervisor, and the Dr office company CEO asking for them to remove the bill from my file. The supervisor said she was on it. 2 weeks have passed and I have not gotten an update. My question is-where do I go from here? How much higher up the chain do I go? Do I legally have a leg to stand on? Do I just call the iTeam at the local news station and put them on blast? I have every email printed, and documented every date and time I called, who I spoke to, and recorded call IDs. Any help is appreciated.
submitted by /u/sonrisa46
[link] [comments]
LONG POST-North Carolina-My pain management doctor is with a small anesthesia company inside a large hospital system. April 24th, I got a call that my doctor was no longer in network. I immediately called my HR dept who told me to fill out a Continuation of Care (CoC). This would allow me to finish my treatment plan as an in network patient. I immediately filled it out, drove to the drs office with a post it note with that they needed to fill out and what # to fax it to. They said they would. A week later, I called United Healthcare (UHC-my insurance company) to see if they had received the CoC and they didn’t. I called the drs office to ask why they didn’t send and the woman told me that bc I had an out of network plan, I didn’t need this form. I told her I did and if she would please send the paperwork back to me and I would fax it over myself. She did and I immediately faxed it over on May 8th. I called UHC again and asked the CSR if I could explain what I thought the CoC was, I did, and the CSR agreed. The CoC is denied. I call UHC to ask why and they stated that I had 30 days from the day I was considered out of network, which would have been April 1st. I immediately call the drs office and let them know what’s going on. That they were supposed to inform me April 1, not April 24, and that because the Continuation of Care wasn’t faxed within 30 days, I was denied. I was connected to a supervisor at the drs office who told me that again, I didn’t need a CoC bc I had an out of network plan. I yelled at her said that someone was lying and I’m damn sure it’s not UHC. She said she would contact UHC and call me back. She called back and admitted their office was wrong. I filed another appeal-denied. UHC tells me that the dr office has to file it. The drs office fills out the appeal, and said it would take up to 30 days. This was in July. I have been emailing every month since then asking for an update. They said they still have not heard any result. On Jan 10th, I got a bill for $22,442.65. I emailed the drs office contact, the supervisor, and the Dr office company CEO asking for them to remove the bill from my file. The supervisor said she was on it. 2 weeks have passed and I have not gotten an update. My question is-where do I go from here? How much higher up the chain do I go? Do I legally have a leg to stand on? Do I just call the iTeam at the local news station and put them on blast? I have every email printed, and documented every date and time I called, who I spoke to, and recorded call IDs. Any help is appreciated.
submitted by /u/sonrisa46 [link] [comments]Read Morer/HealthInsurance