MY UNICARE POLICY WAS ACTIVE WHEN I HAD THE BABY. ALL THE HOSPITAL CHARGES WERE PAID. I HAVE AN HMO AND UNICARE DENIED PAYMENT ON MY BABY FOR A DR JEFFREY FOREMAN WHOSE OFFICE IN THE FIRST PLACE DID NOT SUBMIT THE CORRECT CLAIM TO MY HMO SITE. INSTEAD THEY SUBMITTED IT TO UNICARE DIRECTLY. THEN SAHAR FROM THE HMO SITE ALSO SAID THAT SINCE UNICARE DENIED COVERAGE FOR MY SON, UNICARE HAS TO PAY IT SINCE IT IS 4 YEARS OLD. DID SAHAR NOT THINK WHY UNICARE THEN PAID MY CLAIMS SINCE I HAD THE BABAY, I AM AT LEAST ALLOWED 30 DAYS TO FILE INFO RE: MY BABY. DID UNICARE OR MY IPA SITE RUSH NORTH SHORE PRACTICE ORGANIZATION (NOT A SINGLE PERSON) THOUGHT THAT SINCE THEN I HAD MATERNITY CHECK UPS, ULTRASOUNDS ETC AND THOSE WERE PAID.
I HAVE CALLED MYSELF AND TOLD UNICARE ABOUT THAT I AM HAVING A BABY AND NOW THAT DR JEFFREY FOREMANS OFFICE SENT ME TO COLLECTIONS, HOW I HATE PEOPLE WHO ARE NOT DOING THEIR JOB. EVEN SAHAR FROM THE HMO SITE, GRRRRR...
I HAVE MADE PHONE CALLS NOW, PER BEGONIA FROM DR JEFFREY FOREMANS AND SAHAR TOLD ME YESTERDAY THAT THESE 2 PEOPLE HAVE SPOKEN ABOUT MY BALANCE AND DECIDED THAT MY SON DID NOT HAVE COVERAGE. WHO IS SHE, MAKING THE DECISIONS, I HOPE SHE DOES NOT HAVE ANY KIDS, HOPE THIS WILL NOT HAPPEN TO HER.
I HAVE SPOKEN TO SAHAR JUST NOW AND SHES ALSO SAYING THAT EVEN IF UNICARE REPROCESSED AND ADJUSTED CLAIMS ON 03-05-2009 THEY WILL NOT PAY IT BECUASE IT IS 4 YEARS OLD. GRRR...
I CALLED UNICARE AGAIN AND SPOKE TO A SUPERVISOR WHO WAS SAYING THAT BABY COVERAGE WAS OCT 1, 2005 BUT THAT DATE STILL FALLS WITHIN THE 30 DAY FILING OF NEWBORN.
MY SUPERVISOR LAURA NEGLIA HAD SHOWN ME HER FAXD CONFIRMATION TO UNICARE ON SEPT 16 2005 ABOUT INCLUDING MY SON MILES FOR MEDICAL COVERAGE. NOW DENISE IS SAYING SHE NEED TO MAKE A FEW PHONE CALLS AND CHECK WHO IS RESPONSIBLE PAYING FOR THAT AND SHE WAS TALKING ABOUT CAPITAION...
ALL THIS IS GIVING ME FRUSTRATIONS AND HEADACHES AND WASTE OF MY TIME... THAT WAS THE REASON WHY I CHOSE HMO.. THIS MDS WHO JUST POP OUT OF NOWHERE WHEN I CANNOT MAKE A DECISION FOR MYSLEF SHOULD JUST NOT POP UP OUT OF NOWHERE AND NOW WANTS THEIR MONEY. I HAVE AN HMO, I DO NOT WANT AN MD WHO IS OUT OF NETWORK AND THAT I DO NOT KNOW. THAT WHY I CHOCE MY OWN MDS BECUASE I TRUST THEM.
THERE SHOULD BE A LAW AGAINST THIS MDS WHO ARE CALLED IN SURGERIES (I DONT CARE WHAT KIND OF SURGERY) WITHOUT THE PATIENT OR FAMILY MEMBER BEING NOTIFIED AND THERE SHOULD BE A WRITTEN DOCUMENTATION WHY THEY ARE THERE AND THAT THEY ARE AWARE WHAT KIND OF INSURANCE THE PATIENT HAS. IF THEY HAVE TO LEAVE, LEEEAAVE !!! GOD I DON'T NEED THIS HEADACHE.
I CANNOT FUNCTION WHEN SOMETHING LIKE THIS IS HOVERING ON TOP OF MY HEAD. ASIDE FROM ALL THE OTHER PROBLEMS I HAVE IN LIFE. I THOUGHT HAVING AN HMO INSURANCE WILL BE WORRY FREE. I TRY NOT TO BE SICK. TAKE CARE OF THE KIDS AND MY HUSBAND AND NOW THIS. OF ALL THINGS. ...
HOPE SOMEONE READS THIS AND HELP ME SUE THEM IF UNICARE OR MY HMO SITE DOES NOT PAY.

DESPERATELY NEEDING HELP,
MILDRED A.