What If Services Are Denied As Out-Of-Network?
The patient must be covered under an HMO or managed care insurance contract and a pre-authorization request must be denied because the service is not available in-network and the health plan recommends an alternate in-network service that it believes is not materially different from the out-of-network service. The patient’s physician must complete and send pages 4-6 of the application to the Insurance Department.
Related Questions
- What will happen to the jobs, goods and services provided by a corporation if it is denied permission to exist in California because it is a 3 strikes offender?
- Does the POS CIGNA PLAN ever pay 100% for out-of-network major medical services?
- Do in- and out-of-network services apply towards the same deductible?
