Berkeley Parents Recommendations for Legal & Financial

Attorney for Health Insurance

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August 2001

I've got a problem in need of legal backing. Basically I started work with a new employer, specified who our primary health care providers should be within the medical plan (PacifiCare), but somehow the employer didn't transmit the correct information to the medical plan. End result - I have tons of medical bills and the plan doesn't want to pay because they say we've been going to the wrong doctors (though no one ever said anything - doctors, medical plan, etc.) Can anyone recommend a lawyer I can get an initial consultation with to see can be done? Jonathan

I couldn't get the whole picture from your posting, however, we recently got ourselves out of a similar situation. My primary physician and his group were no longer in my PPO, however the office never told me (so the bills added up). A second issue was a lab bill that wasn't submitted in time. Bottom line we were able to talk to my husband's employer who was able to authorize an override to the administrative company to go ahead and pay these bills anyway. Feel free to email me if you would like to discuss this further. I have a couple of friends with medical insurance experience who were able to help me. You may not even need to hire an attorney for your situation. Felicia ----------------- If your health plan is an HMO, it's worth contacting the Department of Managed Care's HMO Help line. You can call (888) HMO-2219 or (877) 688-9891 (TDD). Also, check out the agency's web site, www.dmhc.ca.gov You might also call Bay Area Legal Aid ("BALA") for a referral to a private lawyer versed in employment and health care issues. In Alameda County, the phone number for BALA is (510) 663-4744. In Contra Costa, it's (510) 233-9954. Ellern
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