How to Deal with Underpays or Delays by Your Health Insurer
Whether you have OSCAR Health Plan of California or another healthcare insurer, you may have experienced being denied coverage for a necessary test, procedure, or prescription drug. Such a denial can send your world into a tailspin. What will you do when you cannot afford to pay for the procedure, test, or prescription drug out-of-pocket? You may be wondering what steps you need to take to address this injustice but are too busy trying to keep your head above water financially while experiencing a healthcare issue that you simply do not know which way to turn. Here’s what you need to know: All it takes is one solid advocate in your corner—one person, one law firm that is willing and able to fight for you. One advocate that genuinely cares about your health and your future.
Attorney Scott Glovsky is the lawyer you need at this moment in time. At the Law Offices of Scott Glovsky, we fight for every one of our clients as we work to force their insurance companies to change their behavior and follow through with the commitments they made to you when you signed on. Using every legal measure at our disposal, we will work hard to force your insurance company to do the right thing. Attorney Scott Glovsky can beat up your insurance company—just ask Anthem Blue Cross, Blue Shield of California, Health Net, Kaiser, Aetna, United Healthcare, and OSCAR.
About OSCAR Health Plan of California
OSCAR is one of the newer health insurance companies and was founded in 2012 with a technology and telemedicine focus. OSCAR now serves more than 420,000 members and is planning to expand to 18 states and 286 counties in 2021. OSCAR started offering individual insurance plans in California in 2016 and is available as a health insurance option for those living in both Los Angeles and Orange Counties.
When OSCAR Health Plan of California Denies Your Claim, Delays, or Underpays
It can be demoralizing to have your healthcare claim denied. You may desperately need a test, a procedure, or a specific prescription medication, yet insurance denies your claim. If you cannot afford to pay out-of-pocket (and most people cannot), where will you turn? You have the right to appeal a decision made by your health insurance company, and Scott Glovsky can help you do just that. At the Law Offices of Scott Glovsky, we can help you manage a health insurance denial by comprehensively reviewing your current health insurance policy, then pursuing all legal avenues to access your right to healthcare coverage.
What Are Common Reasons OSCAR Health Plan of California Claims are Denied?
Perhaps your issue needs to be resolved with a lawsuit claiming bad faith filed against OSCAR Health Plan of California. If insurance denies your claim with no apparent justification, the Law Offices of Scott Glovsky will file such a lawsuit. OSCAR Health Plan of California may deny a claim for many different reasons. There could be an omission of details, clerical error, or billing code mistake. Other times, OSCAR Health Plan of California could deny a claim under the guise of “medically not necessary.” This can be frustrating when your doctor has told you that you need the procedure, the test, or the prescription drug. Sometimes, an insurance company may claim your treatment is too “experimental.” When your treatment is something as simple as a CT scan, an x-ray, or an MRI, being told the treatment is too experimental can be very frustrating.
Should You File an Appeal Against OSCAR Health Plan of California?
If OSCAR Health Plan of California consistently engages in health insurance delays and underpayments or has flat-out denied your claim, it is essential to know that California law mandates health insurance companies must provide timely access to care. Filing an appeal means you ask your healthcare company to review your information and change a coverage decision. A grievance is any complaint about something other than a coverage decision. If you complain about how OSCAR Health Plan of California is treating you, you will file a grievance. It can be overwhelming to file an appeal or grievance on your own because there are ways and dates it will need to be filed. The Law Offices of Scott Glovsky can help you file your appeal or grievance in a way that has a better chance of success.
News Related to OSCAR Health Plan of California
OSCAR Health Plan of California’s parent company was investigated for wrongly informing those insured under their plan that many of the providers listed as in-network on the provider list were actually out-of-network. This meant that many services, procedures, and tests were denied payment. Not only were claims wrongly rejected, but those insured by OSCAR spent extra time attempting to find an in-network doctor.
Summaries of Cases That We Have Filed
In addition to these example case summaries, please view a full list of our results and client testimonials.
- We filed a case against Oscar Health Plan of California for denying a medically necessary MRI for our client. Our client had numbness and weakness in his lower extremities. His doctors requested MRIs to determine the cause of his symptoms. However, Oscar Health Plan denied the crucial requests, delaying his care for months and causing lasting physical injury and emotional distress. Our lawsuit alleges that Oscar’s system for reviewing requests for medical care is designed to deny medically necessary care to its subscribers, placing barriers in the way of members receiving necessary care and designed to save money for Oscar. As a result of Oscar’s wrongful denial, our client suffered physical injury, emotional distress, and other damages. We are suing Oscar for breach of the duty of good faith and fair dealing, breach of contract, and violation of Business & Professions Code Section 17200.
- We filed a case against Oscar Health Plan for denying medically necessary emergency treatment. Our client, nine months pregnant, had a traumatic injury after a head-on collision and was rushed to the hospital. Oscar denied coverage for these emergency services and our client was left with tens of thousands of dollars in medical bills. Our lawsuit alleges that Oscar’s utilization review system systemically fails to conduct full, fair, and thorough investigations before denying coverage. We are suing Oscar for breach of implied covenant of good faith and fair dealing, breach of contract, and violations of Business & Professions Code Section 17200.
How the Law Offices of Scott Glovsky Can Help with OSCAR Health Plan of California Delays, Underpays, or Denials
If OSCAR Health Plan of California denied a service, treatment, test, or prescription drug, the Law Offices of Scott Glovsky can help you during this difficult time. We understand that you may be feeling vulnerable, unsure of what you should do next for your health and your future. You may be ill and unable to “fight” with your insurance company, even when it is for something you need desperately. Attorney Scott Glovsky will remove this burden from you, giving you the time to concentrate on your health while he fights for your health, your future, and your rights. At the Law Offices of Scott Glovsky, we will file an appeal 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 OSCAR Health Plan of California—or any large healthcare company.
