How to Deal with Underpays or Delays by Your Health Insurer
Trusted Lawyer Scott Glovsky Can Help
It can be genuinely earth-shattering when your health insurer refuses to pay for a necessary treatment, procedure, test, or prescription drug. Such a denial—along with chronic delays and underpays—can leave you shaken, wondering where you will turn for the justice you need and deserve. After all, you have been faithfully paying your healthcare premiums for months, years, even decades. Then when you need your insurance company to step forward and help you, suddenly, you are treated like just another claim number. What do you need at this moment in your life? You need an advocate—someone who will fight for you, your future, and your rights.
Attorney Scott Glovsky works hard on behalf of people just like you, day in and day out. At the Law Offices of Scott Glovsky, we fully comprehend the damage denials, delays, and underpays can do to families who may already be struggling just to get by. We use our knowledge and experience to force insurance companies to change their behavior and do the right thing. Perhaps they need to rethink their current system of reviewing requests for medically necessary treatments. Or, maybe they need to look again at a denial based on out of network services. We believe you are entitled to the insurance you have paid money for, and we also believe our record speaks for itself. We have gone up against the biggest insurance companies, including Anthem Blue Cross, United Healthcare, Aetna, Kaiser, Health Net, and Blue Shield of California.
About Magellan Healthcare
Magellan Health, Inc., is a Fortune 500 company whose customers are third-party administrators, managed care organizations, governmental agencies, military agencies, employers, and labor unions. Magellan Health was launched in 2015 as a nonprofit organization that has more than 10,500 employees.
What To Do When Magellan Healthcare Denies Your Claim, or Delays or Underpays Your Claim
Unfortunately, like other healthcare insurance companies, Magellan Healthcare may sometimes deny, delay, or underpay a claim. Even the best healthcare companies can make a mistake, and those mistakes need to be addressed and corrected. You assumed—rightly—that when you signed up with Magellan Healthcare and paid your premiums faithfully, it would take care of you in return during the times you need it most. Having a claim for a necessary procedure, test, or prescription drug denied can be devastating, leaving you struggling with significant medical expenses.
Few Americans have the financial resources to pay for medical tests, surgical procedures, or expensive prescription drugs independently. If Magellan Healthcare denied your claim for no good reason, you have the right to appeal that decision. Attorney Scott Glovsky can help you manage a health insurance denial from Magellan Healthcare by reviewing your current policy, then pursuing all legal avenues to preserve your healthcare coverage.
What Are Common Reasons Magellan Healthcare Claims are Denied?
Perhaps your case will require a lawsuit claiming bad faith filed against Magellan Healthcare for a denial. Magellan Healthcare—along with other healthcare providers—may have a set of “reasons” for denying treatment. Some of these reasons could be legitimate, while others may be less legitimate. The most common reasons any healthcare company denies a claim include claims the procedure is investigational, a determination that the procedure is medically unnecessary, out-of-network providers, errors in the claim submission, or a coding error.
Unfortunately, insurance often deems a legitimate procedure “investigational” when it is medically appropriate and medically necessary. Magellan Healthcare could also delay or underpay your claims, even though California law requires health insurance companies to provide timely access to care. Health insurance delays can cause a delay in prompt payment for a specific medical test or procedure or a delay in the official denial of a specific medical test or procedure.
Should You File an Appeal or Grievances Against Magellan Healthcare When They Deny a Claim?
If insurance flat out denies your healthcare claim for a test, procedure, or prescription drug, then you can appeal the decision. Perhaps your attorney will add new information or solicit information from other doctors and healthcare providers showing the test, procedure, or prescription drug is warranted and necessary. A grievance is filed when your healthcare company is behaving in a manner that you believe is unwarranted—in other words, suppose your statements are consistently late, or the person you talk to is always rude.
If you need to file an appeal, it can seem like an overwhelming proposition that will benefit significantly from having an experienced attorney from the Law Offices of Scott Glovsky on board. When you turn over your appeal to Scott Glovsky, you can forget some of the stress the denial is causing you, allowing Scott to take care of the matter.
News Related to Magellan Healthcare
In 2004, Magellan Healthcare—the nation’s largest managed behavioral health company at the time—filed for bankruptcy, claiming $1 billion in debt. Magellan Healthcare served 67 million people; Magellan emerged from the bankruptcy with debts cut by $600 million. The financial reorganization allowed those insured to keep their health insurance. Since that time, Magellan has seemingly managed its money in a better manner.
How the Law Offices of Scott Glovsky Can Help with Magellan Healthcare Delays, Underpays, or Denials
Perhaps Magellan Healthcare has consistently underpaid or delayed your healthcare claims or has outright denied your healthcare claim. Magellan may have denied your claim for various reasons, but when you need the medical procedure, test, or prescription drug, it can be a devastating blow. The Law Offices of Scott Glovsky have helped many people who find themselves in the same situation. We can file an appeal or grievance on your behalf, create a case before the California Review Board, or argue your case in court. Contact the Law Offices of Scott Glovsky today—we have the experience, knowledge, and skills to go up against Magellan Healthcare—or any large healthcare company.