Blog Posts in July, 2012

  • Why You Need to Know Your Policy

    || 25-Jul-2012

    Save Those Envelopes! Our client is covered by an employer sponsored group plan based in New York. The Plan denied our client's residential treatment for her anorexia based upon medical necessity. We submitted a timely appeal. On April 23, 2012, we received the Plan's response denying the appeal based upon medical necessity. The appeal denial is dated April 11, 2012. Since it seemed odd we ...
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  • In the first lawsuit of its kind, the California Medical Assn., three county medical groups, four surgery centers, more than 60 individual doctors, and one patient are suing insurer Aetna Inc. in Los Angeles Superior Court for threatening to deny benefits to policyholders who go "outside the network" for treatment, even though their policies allow out-of-network treatment. The lawsuit ...
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