A Denial Strategy?

[k9ophile]

I don't know if this would work, but it sure does make me think it may be worth a shot. Smarter minds than mine: please feel free to share your knowledge or experience.

 

[DianaCox]

You can try - I did, and they just ignored me. I filed a complaint with OCR and never heard back from them.

 

[DianaCox]

http://bariatricfacts.org/threads/insurance-denial-trick.3800/#post-60165

My post, and BebeZed's response:

I'm dubious, but it it won't cost anything the try before filing an actual appeal. Saw this on the innerwebs - copied, except for my apparentlys and supposedlys. I don't know that this works.

The next time your insurance denies a test or procedure:​

1. 1. 1. Call the insurance company and tell them you want to speak with their "HIPAA Compliance/Privacy Officer" (apparently, it is federal law that they are required to have one).
      2. Then ask them for the NAMES as well as CREDENTIALS of every person who has accessed your medical record to make that decision/denial. Again supposedly by law, you have a right to that information.
      3. They allegedly will almost always reverse the decision very shortly rather than admit that the committee is made of low paid HS graduates, looking at "criteria words," making the medical decision to deny your care. Even in the rare case it is made by medical personnel, it is unlikely that it is made by a board certified doctors in that specialty and they DON'T WANT YOU TO KNOW THIS!
      4. Any refusal should be reported to the US Office of Civil Rights (OCR.gov http://www.hhs.gov/ocr/privacy/) as a HIPAA violation.

And please let me know how it goes!​

Edited to correct the website for filing the HIPAA complaint.
Snopes and other sites says this isn't exactly true - there's some false information included in the above.
http://www.snopes.com/hipaa-medical-hack-insurance-claim-denials/
http://hipaahealthlaw.foxrothschild...egorized/debunking-a-viral-medical-hack-meme/​

 

[Larra]

I seem to recall that this isn't accurate info, yet another internet thing. However, it would certainly put your insurer on notice that you mean business.

 

[k9ophile]

I think it would be fun just to mess with their heads. However, they'd probably be vindictive bastards and make getting any claim settled to be nothing but hell. Oh, well. It does make for fun day dreaming.