Health Net Conflicting Information
I'm wondering if anyone else has had an issue like this....I have Health Net NorthEast, Charter plan. I work as a Manager for Health Net Federal Services, another subsidiary of Health Net. Before the surgery, I logged onto my insurance plan information and thoroughly researched what was required for this surgery. I checked the dates on the plan updates to make sure I had the most recent information. I followed all the preauthorization requirements. My Dr submitted the request for the surgery and I received a denial stating that it wasn't covered under my plan. They listed the exclusion information, but I could not find it anywhere under my account information. I had put my heart and soul into preparing for this operation, and decided I was going to take the money out of my retirement and have it done anyway. At the rate I was going, I wouldn't be around to see my retirement anyway, I may as well get some use out of it now! In the meantime, when I received my denial letter, they sent a cc to a different doctor and a different hospital, with a different surgery date. They sent it to the OB and the hospital where I delivered my baby, with the surgery date exactly 1 year after my baby was born, rather than my Bariatric Surgeon and the Hospital where he was doing the surgery. Now the problem with this is that I work with both this hospital and OB on a daily basis in my job. I am embarassed and feel this is a HIPAA violation. I am awaiting a decision on my first appeal. I feel that the odds are stacked against me, and the fact that these additional providers are now aware of a procedure that I had done that they have no business knowing about is a huge privacy violation. Do I have any recourse in this matter?
Julie