NY HMO Script – Maternity Coverage
May 5, 2021 1:18 amASK YOURSELF: Did we verify eligibility? IF SO, WHAT DATE? Did the plan make negligent misrepresentation of the patient’s eligibility?... View more
Archives
NY HMO Script – Interest Owed on Late Claims
May 5, 2021 1:12 amASK YOURSELF: What date was the claim initially billed? What date was the claim paid? Did they pay this claim... View more
NY HMO Script – Non-urgent Authorization Timeframes
May 5, 2021 1:02 amASK YOURSELF: What date was the request for non-urgent authorization made? Was there any written communication (request for information, denial,... View more
NY HMO Appeal – Untimely Payment
May 5, 2021 12:56 amURGENT- IMPERATIVE ACTION Dear Director of : This office has been asked to file a formal complaint with the NY... View more
NY HMO Appeal – Retroactive Denial for Authorized Care
May 5, 2021 12:41 amIMPERATIVE-ACTION REQUIRED Dear Director of : This office has been asked to file a formal complaint with the NY Department... View more
NY HMO Appeal – Refund Recoupment
May 5, 2021 12:25 amIMPERATIVE-ACTION REQUIRED Dear Director of : This office has been asked to file a formal complaint with the NY Department of... View more
NY HMO Appeal – Poststabilization Timeframe
May 5, 2021 12:05 amIMPERATIVE-ACTION REQUIRED Dear Director of : This office has been asked to file a formal complaint with the NY Department of... View more
NY HMO Appeal – Notice Requirements for Adverse Determinations
May 5, 2021 12:02 amURGENT-IMPERATIVE-ACTION Dear Director of : This office has been asked to file a formal complaint with the NY Department of Financial... View more
NY HMO Appeal – No Authorization for ER Services and Care
May 4, 2021 11:54 pmURGENT-IMPERATIVE-ACTION Dear Director of : This office has been asked to file a formal complaint with the NY Department of Financial... View more
NY HMO Appeal – Medical Necessity – Qualified Reviewers
May 4, 2021 11:49 pmURGENT-IMPERATIVE-ACTION Dear Director of : This office has been asked to file a formal complaint with the NY Department of Financial... View more