Medical Disputes
Date: Fri, 04/29/2005 - 11:48
Medical Disputes
A Consumer Guide to Handling Disputes with Your Employer or Private Health Plan, 2003 Update
www.consumersunion.org/health/hmo-review/
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* If you can please allow this one link, I know it is not a government link, but it is a very important link to help people out with medical insurance disputes. Thanks
www.consumersunion.org/health/hmo-review/
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A growing number of people get their health care through some form of managed care plan - a health maintenance organization, preferred provider organization, or point-of-service option. Most of the time, people receive the care they need, but the potential exists for disagreements over the services that will be provided or paid for by health plans. Health plans are required to follow state and federal rules for handling their enrollee's complaints and appeals inside the health plan, known as an "internal review." Many states have legislated additional procedures outside of the health plan, called "external reviews" or "independent reviews," to provide an unbiased way to resolve disputes between patients and their health plans. An external review is a reconsideration of a health plan's denial of service, with the review conducted by a person or panel of individuals who are not part of the plan. As of August 2002, 41 states plus the District of Columbia had legislated such procedures. Anyone enrolled in a health plan should be familiar with their plan's internal review process and any external review program in their state in case problems later arise. This guide will help you navigate your employer or private health plan's internal review procedure, as well as any external review program your state may have. The guide is not applicable, however, for resolving disputes if you have Medicare or Medicaid coverage. |
* If you can please allow this one link, I know it is not a government link, but it is a very important link to help people out with medical insurance disputes. Thanks
When disputing medical that you know was suppose to have been co
When disputing medical that you know was suppose to have been covered by insurance then there are a few things you need to do.
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Need copies of all correspondence from each company, need to forward from one to the next as you go down the list of companies involved with the reporting.
Another thing about medical debt with credit reporting, as of last year the credit reporting agencies are no longer allowed to disclose the name and address of the medical provider to creditors viewing the credit report, so if you purchase a credit report from a reseller, or obtained from a creditor you may not be able to identify the medical provider until you contact the credit reporting agency directly yourself to obtain a copy from them.
Hi Pammila I think this medical dispute is a tough subject to
Hi Pammila
I think this medical dispute is a tough subject to deal with. But you have explained it very nicely and it will be of great help to the consumers.
Thanks for the information
Regards
Roxette