Posts Tagged HMO
Write a Certified Mail, Return Receipt Requested Letter to the Appropriate Person at the HMO Part 2
Posted by Dave in Business, Information on March 24, 2012
If the person reviewing your letter feels you are making a good case for your state agency or a potential lawsuit, the HMO will think twice about continuing to deny the requested medical care. If such letters find their way to lawyers for the HMO, and the lawyers feel that the HMO is threatened by [...]
Write a Certified Mail, Return Receipt Requested Letter to the Appropriate Person at the HMO Part 1
Posted by Dave in Business, Information on March 20, 2012
A letter from you sent in this fashion is a wake-up call when an HMO receives it. It knows, because you have taken the time and spent the money to have the letter certified, that you are taking the matter very seriously. It also knows, since someone in the HMO must sign the receipt, that [...]
Resolving Disputes Part 2
Posted by Dave in Business, Information on March 16, 2012
Checklist for Resolving Disputes with Your HMO -Discuss the matter thoroughly with your primary care physician -Discuss the matter thoroughly with the appropriate HMO representative -Write a certified mail, return receipt requested letter to the appropriate person at the HMO -Utilize the review procedure set forth in your provider agreement -Request a review [...]
Resolving Disputes Part 1
Posted by Dave in Business, Information on March 12, 2012
Although the techniques previously mentioned for further testing work a good deal of the time, there are situations when a member of an HMO cannot obtain the treatment he or she feels is necessary, no matter what informal steps are taken. When that occurs, you will need to resort to formal steps to provide you [...]
