Fighting Back Against Regal Medical Group Claim Denial
You pay your health and disability insurance premiums every month. Whether you pay for your health insurance separately or the premiums are deducted directly from your paycheck when you sign up for coverage, you expect coverage. When you suffer an injury or disability, you have the right to expect that you’ll be able to get the care that you need and that your bills will be paid or reimbursed. Unfortunately, insurance companies are constantly on the hunt for any reason to deny coverage and protect their own pockets. They’ll look for any possible excuse to deny coverage, often stretching the facts or even deliberately misleading their own policies to justify claim denial. In many cases, they will engage in bad faith or underhanded tactics to get you to drop your claim or accept a lowball offer, such as by unjustifiably delaying their investigation of your claims.
If you need medical care or you’ve received a large bill and your insurance company is being intransigent, a seasoned insurance bad faith and claim denial lawyer at Gianelli & Morris can help you get the medical care and the compensation you are owed. We’ll go toe-to-toe with insurance companies standing in the way of you getting the medical care you need without going bankrupt in the process.
Who is Regal Medical Group?
Regal Medical Group is one of the largest physician-led medical groups in Southern California. They have more than three thousand primary care physicians (PCPs) and over 10,000 specialists. Regal is a member of the Heritage Provider Network. They’ve provided a range of medical services for over thirty years, including services in family medicine, obstetrics, gynecology, cardiology, urology, pediatrics, and others.
A medical group serves as the access point between the patient and their health plan. Anyone with HMO (health maintenance organization) coverage through their employer must choose a medical group. Joining a medical group means gaining access to the network of PCPs, specialists, urgent care providers, and other services. It also means subjecting yourself to the restrictions and rules imposed by the medical group.
The medical group is there to represent the interests of the physicians. The group is not there to protect you or your rights, and they are certainly not there to advocate for you against the insurance company. If your Regal Medical Group claims are denied, you’re on your own to prove you deserve coverage. Regal has, in fact, been hit with several Better Business Bureau claims over the years with regard to shady practices and improper treatment denial.
Why Claims With Regal Medical Group Get Denied
Insurers have turned claim denial into a science. They have a laundry list of reasons for denying coverage, some legitimate and some ridiculous. There may be proper reasons for denial: You may have left necessary information out of your claim forms, or you may have utilized an out-of-network provider for services. You may have obtained treatment that was deemed not to be “medically necessary.” Just because your claims have been denied, however, does not mean that you are not entitled to coverage.
If there are errors on your claim or evidence missing, you should be able to fix up your claims and provide the necessary information. If your insurer states that your treatments aren’t covered, they may be stretching the truth. Many types of treatment can be deemed “cosmetic” or otherwise medically unnecessary when viewed through a very narrow lens, even when your doctor recommended the treatment. If your insurer rejects your claim, you have the right to file an appeal and you can even pursue your claims through a civil court proceeding.
The experienced claim denial and bad faith lawyers at Gianelli & Morris are ready to review your case and find out if you should be entitled to coverage. If there’s a pathway to compensation and getting the healthcare you need, we’ll find it.
Call Gianelli & Morris After a Wrongful Regal Medical Group Claim Denial or Bad Faith Conduct by a California Insurance Company
If you or someone you care about has had a claim with Regal Medical Group wrongfully denied, or if your insurance company has subjected you to insurance bad faith conduct, call the experienced and effective Los Angeles insurance denial lawyers Gianelli & Morris for a no-cost evaluation of your claim at 213-489-1600.