Insurance companies that reduce claims

HearWHAC HearWHAC at netins.net
Mon Aug 26 23:54:07 EST 1996


The following letter was recently given to me. We are using it, although 
with discretion. It does make an interesting point.

Paul ;-)


(Letter To Insurance Company)
Name of Person Handling Claim
Insurance Company Denying Full Payment of Claim
Address of Insurance Company

Dear:

Libel is a serious offense in this state. It has come to my attention that 
your company has notified my patient, whose claim is attached, that you feel 
that our fees are above the usual and customary or normal rate for this 
community. I consider this to be untrue and libelous. What I believe you 
have the right to say is that your company is unwilling or unable to pay for 
the standard of hearing aid care that is needed by the patient and chosen by 
him.

You must be prepared to substantiate your opinion of my charges in a court 
of law or notify the patient in the attached claim that you are retracting 
your assertion about my fees.

I also suggest that you seriously consider rephrasing your communications to 
accurately reflect your company’s ability to reimburse or cease and desist 
with your present communications, which are inaccurate and intrusive in the 
audiologist/patient relationship.

Sincerely,


(Your Name)

cc: Joe Jones, Insurance Commissioner
Our Attorney

Enclosure:  Insurance claim and documentation






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