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In a recent post, we reported on a Department of Managed Health Care (DMHC) survey of the quality of care offered by Anthem Blue Cross to its California policyholders. The survey found 14 serious shortcomings, ten of which were shortcomings in the manner in which Anthem operated its customer grievance system. The DMHC’s report... Read More »
By Gianelli & Morris Posted on November 29, 2019
A recent California state agency review of the service provided by Anthem Blue Cross to its policyholders found the healthcare provider deficient in fourteen significant ways. When the agency gave Anthem a second chance to improve its performance score, the insurer showed improvement in only one of the fourteen deficient areas. Learn more about... Read More »
By Gianelli & Morris Posted on November 15, 2019
The California Department of Managed Health Care (DMHC) conducts routine surveys of every California health care service plan at least once every three years, examining such factors as how each plan addresses customer grievances, how it makes health care services available, and the access to and payment for emergency services that it provides to... Read More »
By Gianelli & Morris Posted on October 31, 2019
Recently, we published an article on denials of claims for health insurance benefits as “experimental,” one of the most-commonly-used excuses for the denial of a health insurance claim. Another commonly-provided reason for California health insurance claim denials is that the sought-after treatment is not medically necessary. Like denials based on the alleged experimental nature... Read More »
By Gianelli & Morris Posted on October 25, 2019
Recovering fully from a severe illness can be a race against the clock. Once your physician has diagnosed your condition and determined the best course of treatment, you naturally want to start that treatment as soon as possible. Most medical conditions will get worse without treatment, and some can even go from treatable to... Read More »
By Gianelli & Morris Posted on October 17, 2019