Legal Question in Insurance Law in California

Patient Care Dispute
Are there any concrete steps a patient can take to determine the type/level/place/quality of care she can receive, when the insurance company has determined these issues already? Specifically, the insurance company has sent her to a teaching hospital for her leukemia, when there is a well-known specialist center at a nearby, private hospital. Her appeal to try to switch hospitals was denied.

Asked on 9/28/00, 12:14 pm

Steven Murray Steven W. Murray, APC

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Re: Patient Care Dispute

Your question implies you belong to an HMO type

health insurer. If so, your doctor is the one

to assist you since the doctor can "prescribe"

the "right" medical care for a patient.

If not, is the "specialist" hospital in your network?

Perhaps your insurer pays less than for the teaching

hospital, but will pay something. You can call

the social workers at the "specialist" hospital and

tell them your problem and see if they can assist.

In all cases, the treating physician is an integral

part of obtaining what you believe is the best

medical care.

Good luck - please contact me if you have any further

questions.

S. Murray

(818) 501-2277

Answered on 10/28/00, 4:57 pm

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