Question
I was diagnosed with cancer 2 months into a new personal policy. The health insurance company has suspended my account pending an eligibility investigation. Some of the claims say that they suspended, and other say they have not received a full medical history from the doctor/provider and they are looking for a pre-existing condition. The original claim that triggered this was 4 months ago, and the insurance company denied my grievance which asked for a timetable for the claims to be processed (2695.7 (c) (1) of CA law. Is there anything I can do to speed things up and to get the insurance company to pay the claims? I have called the hospitals and doctors to make sure they've sent everything back but the insurance company keeps dragging their feet and changing their story.
Answer
Hi Daniel!
You are at the mercy of the insurance company unfortunately. However the more you call them the better chance you will get them to process your claims just to get you to stop calling.
You can also threaten them with the local news.....sometimes this gets them to move.
Good Luck!
Tricia
