Health New England Complaint - Claim Denied
SPRINGFIELD, MASSACHUSETTS -- In January, I had a sleep study done that showed I had moderate to severe breathing issues at night, and that my health was at risk. The results also suggested anatomical reasons for the problem, which is also implied by the fact that my 7-year-old son has some related issues. I was recommended for surgery by an ENT specialist and had the surgery scheduled, and the approval sent in to my Health Insurance. More than a month after the approval was sent in, when I had made all my plans around this date (including getting pregnant again after a recent miscarriage) and scheduling time off rom work, Health New England acknowledged that they hadn't bothered to look at it yet. At the start of April, they decided they would deny it and require that I do other tests first. This will make it impossible for me to hold my surgery date. The doctor only does this surgery once per month and books months out. Even if I could get in in a later month, I may not be able to get the time off of work and it will disrupt many other plans, including my ability to get pregnant and will force me to live with a dangerous condition longer than is necessary.
Furthermore, the tests are not necessary, as the results are already known based on the existing tests and information available. This denial is based on no more than Health New England's rigidity, lack of caring for its customers and inability to look beyond procedures in books that don't necessarily apply to each individual.
In the end, they don't care about me, my life or my health.