Legal Question in Insurance Law in California
Patient Care Dispute
Are there any concrete steps a patient can take to determine the type/level/place/quality of care she can receive, when the insurance company has determined these issues already? Specifically, the insurance company has sent her to a teaching hospital for her leukemia, when there is a well-known specialist center at a nearby, private hospital. Her appeal to try to switch hospitals was denied.
1 Answer from Attorneys
Re: Patient Care Dispute
Your question implies you belong to an HMO type
health insurer. If so, your doctor is the one
to assist you since the doctor can "prescribe"
the "right" medical care for a patient.
If not, is the "specialist" hospital in your network?
Perhaps your insurer pays less than for the teaching
hospital, but will pay something. You can call
the social workers at the "specialist" hospital and
tell them your problem and see if they can assist.
In all cases, the treating physician is an integral
part of obtaining what you believe is the best
medical care.
Good luck - please contact me if you have any further
questions.
S. Murray
(818) 501-2277
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