Look at the attached letter and give me your opinion… I am looking at the pts putting the insurance company on notice of the contractual violation within their pharmacy network… if the insurance company does not respond.. then one can presume that they encourage, condone, implicit in the discrimination, civil rights violations, fraud, pt abuse, denial of service etc.. etc.. If Medicare/Medicaid is involved then the pt is able to kick it upstairs to CMS and of course the insurance commissioner and maybe get an attorney involved with the fraud and pt abuse… healthcare providers are sued all the time for pt abuse in nursing homes..
thoughts ?
Filed under: General Problems
Fantastic letter, the only comment is to use the word “run” instead of “ran” and maybe give a time limit for a response from the insurance company, like “30 days from the date of this letter…”