Let’s face it: “Managed Care Companies” are not in the business of keeping you healthy; they are in the business of making money for their shareholders. Many have outsourced medical management to outside companies, who get paid based on how many surgeries, diagnostic radiological procedures, and prescription requests they deny. That was prescribed by their in-network providers.
If you happen to have a PPO with in-network and out-of-network providers, it becomes more complex; if you go out of network, where they cut the allowable reimbursement, you can be held responsible for the difference, also referred to as balanced billing.
This is where Klein Associates, Inc. comes in! At Klein Associates, Inc., we can deal with any care-related problem and resolve the issue fairly, even if we need to file an internal appeal with your “managed care company” or an external appeal with the regulators. We do not stop until your issue is resolved and to your satisfaction.