Re: Insurance regulatory

[Guest guest]

Carol,

How do I locate the insurance regulatory agency?

Thanks,

[Guest guest]

I am in California. I am also very low functioning right now so I appreciate

your help.

I did contact a watch dog in Sacramento when I had difficulty getting the

testing I needed done by my HMO.

I don't recall who I called or what the number was. This was about 2 years

ago. I do recall it took a lot of calls to get the right number at that time.

I think it was the MS Association that finally helped me make the right

contacts.

I do want to go this way. I will do what I can also.

Thanks,

Kate

[Guest guest]

What state are you in??

[Guest guest]

I've found that " calling " is a waste of time! You must document. I bought a fax

machine. I use my computer (Has spell check!) and I write my confirmations and

fax them. Then print a report of the date and time and ok that it was received.

That is called a " Paper trail " . That is what you need to fight these people. I

bought a book called HMO Hardball. You can find it at http://www.hmohardball.com

The writer explains how HMO's get away with their nonsense and how to get around

them. I realized you have to document. They hang themselves!

Start a fresh trail if you don't have anything to go on. Know the laws of your

state too.

Do a Google search and find the HMO insurance laws of your state. I'm in Indiana

so my specific info is different.

But it should be similar. Our law states that an HMO MUST provide " appropriate "

referrals when necessary, in a " timely " manner.

Put your request for a LLMD in writing to your doctor. Give him two weeks. Then

send a 2nd request to your doctor and keep copies of every thing.

When they reply, read carefully. Make sure you tell them you'd like them to

communicate with you in writing.

And another really important thing, document how you feel. What your symptoms

are. What makes you worse how you are affected. Have family members or

supportive friends write written statements they are willing to stand by about

how your illness affects you.

You must build your case. Otherwise you have no leg to stand on. If you can't

write, find someone who can do it for you. You must write (type) every request.

Keep everything. can't stress that enough.

Please write me off board at

carolkerr@...

Carol

Re: [ ] Insurance regulatory

I am in California. I am also very low functioning right now so I appreciate

your help.

I did contact a watch dog in Sacramento when I had difficulty getting the

testing I needed done by my HMO.

I don't recall who I called or what the number was. This was about 2 years

ago. I do recall it took a lot of calls to get the right number at that time.

I think it was the MS Association that finally helped me make the right

contacts.

I do want to go this way. I will do what I can also.

Thanks,

Kate

[Guest guest]

In a message dated 1/12/04 8:41:27 PM Pacific Standard Time,

CarolKerr@... writes:

Yes. I found this out the hard way, too. I know have MediCal and am in a

whole new ball park.

Once again, it is very difficult to get information.

I've found that " calling " is a waste of time! You must document. I bought a

fax machine. I use my computer (Has spell check!) and I write my confirmations

and fax them. Then print a report of the date and time and ok that it was

received.

That is called a " Paper trail " . That is what you need to fight these people.

I bought a book called HMO Hardball. You can find it at

http://www.hmohardball.com