When your health insurance claim is denied, the appeals process can be daunting, to say the least. Knowing what to say and how to say it can be puzzling, and it comes at a time when you’re already stressed about your health. Recently, new AI-powered health advocate tools have emerged that promise to make... Read More »
Timely access to healthcare isn’t just a regulatory requirement in California; it’s a fundamental right for policyholders under managed care plans. Despite the protection in law, some insurers and health plans fail to meet their obligations, leaving patients without the care they need. The California Department of Managed Health Care (DMHC) enforces these rules,... Read More »
When you or a loved one needs medical care, how soon you can get that care often matters as much as what kind of care you receive. In California, insured patients under managed care plans have legal rights to timely access, meaning that their health plan must ensure covered services are provided without undue... Read More »
As more California residents face health insurance denials for medically necessary care, the need for skilled legal advocacy has never been greater. Insurance companies have a legal and ethical duty to act in good faith, meaning they must handle your claim fairly and promptly. Unfortunately, many fail to live up to that obligation, leaving... Read More »
California law is quite clear. State statutes and regulations require health plans to cover “basic health care services” among other requirements, but even this simple mandate seems beyond the willingness or ability of many health plans to meet. Here’s a look at some of the law’s most basic requirements, along with recent examples of... Read More »
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