Question
My eployer changed health plans when I was 6 mos pregnant and my doctor and hospital were not covered on the new plan. I talked to the insurance company and they told me to file a transition of care form for each provider and if approved they would cover at full benefit so I would not have to change dr or hospital that late in the game. I did. I have the originals I filled out and the fax confirmation that they received all pages. I called to check the status before going to the hospital and got the authorization number. I gave copies of all the forms and authorization to the hospital and Dr's office. Humana HMO still denied all the claims, and now I have collectors coming after me and I am being sued by the collection agency of the Dr. What can I do?
Answer
Hi Kerri!
If you have a written authorization then all you need to do is to send any bill to them with a copy of this proving that all providers were authorized for care. You might also call them and see if they will allow you to fax them the written authorization.
Usually they will stand behind their authorizations so it may just be an error on their part.
Good Luck!
Tricia
