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Insurance Case Manager
#1
Hi, I am not a workers Comp case but saw a post for about same issues I would like advice for. There's 2 different issues if someone could help me with advice. My case is through auto, I was injured at 14yrs old in 1994. I've had the same case manager since my Injury, so we've devolped a kinda friendship. Question 1 Last year I recieved a check through mail from my insurance company, I cashed it and spent the funds, weeks after that I recieved a notice in the mail and a phone call saying that was a mistake it was supposed to go to another agency and we need our money back and now I'm getting letters stateting that I need to make payments or they will take me to court. I don't believe I did anything wrong, or should have to pay the money back.My only income source at this time is social security and its not that much......The second issue, I have always order'd medical supplies for my home and set up monthly shipments. Nothing was said about it, it was a normal thing for me to do. Well about 2years ago to today I have 24 hour nurseing set up, so the supplies that was coming to my house, I was not opening boxes putting them away etc. so I had no idea what I had or how much of each. Now I'm being told I may be under investigation because I have so many supplies. Since cashing the check they sent me , my relationship with my Case Manager and it seems my Insurance company has changed. I recived a perscription from my Dr a couple weeks ago and they are refusing to fill it and she is calling my Dr's to ask them all kinds of questions about why I was givien that perscription. Where does my rights for patient Dr privliage start or end. How much under the law can she get my specific information about with my dr's. Do I have to allow her to attend my Dr apointments ? She has always attended since I was a kid so I thought this was normal and the way things are supposed to go, but latley I don't want her interfering with my conversations with my dr. during apointment times.If anyone could give me a couple tips or advice I would be very greatful..I hope I didnt ramble on to much and I hope most makes since...Thank you
 
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#2
Those who pay the bills are allowed the information necessary to verify acceptable covered medical services.
You can ask that she talk to the doctor about you and your claim separately without you present.
And you are entitled to the same privacy.
Reminder :
........Each state has their own comp system; POST YOUR STATE to get accurate information. Use the search feature to find information from similar questions.
THANKS FOR POSTING.
 
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#3
(06-16-2017, 12:37 AM)1171 Wrote: Those who pay the bills are allowed the information necessary to verify acceptable covered medical services.
You can ask that she talk to the doctor about you and your claim separately without you present.
And you are entitled to the same privacy.

Ok , Thank you
 
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#4
Thanks for reply
 
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