Re: HMO insurance denied specialist.

["Robert A. Fink, M. D." <rafink@xxxxxxx>]

Date sent:              Fri, 30 Jun 2000 02:26:33 -0700
Send reply to:          Parkinson's Information Exchange Network 
<PARKINSN@xxxxxxxxxxxxxxxxxxxx>
From:                   davidmeigs <davidmeigs@xxxxxxxxxxxxx>
Organization:           Microsoft Corporation
Subject:                HMO insurance denied specialist.
To:                     PARKINSN@xxxxxxxxxxxxxxxxxxxx

> Hi all,
>
> I just found out that my insurance co.  denied me to see a
> neuropsychologist.  GRRRR. This referral was made about 1 1/2 weeks
> ago.
>
> I think this may also be  the case with seeing a movement disorder
> specialist.  I haven't heard a word, and its been at least a month
> since the referral.
>
> Anyone out there have any ideas on how to "light a fire" under the
> insurance company's B-hind?
>
> Is this just a game they play to try to get people to pay on their
> own?  I have had to pony up too many times in the past, even after the
> referral was accepted (different co).
>
> Thanks,
> David Meigs
>

You and your doctor need to send in a written demand for an "appeal"
of the decision.  They have to have it reviewed within a certain (short)
timeframe and get back to you with a reason for denial.  If you persist,
they will usually back down.  Do it now.

Best,

Bob


**********************************************
Robert A. Fink, M. D., F.A.C.S., P. C.
2500 Milvia Street  Suite 222
Berkeley, California  94704-2636
Telephone:  510-849-2555   FAX:  510-849-2557
WWW:  



"Ex Tristitia Virtus"

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