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gusrithgen
Guest
- Jurisdiction
- Nebraska
On 4/11/2015 I began experiencing stroke-like symptoms and my wife took me to the ER. They ran a bunch of tests MRI CT etc. The medical claim for that visit was approved. On 4/15/2015 I began experiencing the same symptoms and they ran more tests MRI CT etc and my claim was denied stating itwas medically unnecessary. I have gone through the Blue Cross Blue Shield internal and external appeal process. The first two internal appeals upheld the decision of denied and the external appeal also held up a decision of denied. The reason in all three cases stated medically unnecessary. BCBS is not being consistent Or the hospital ordered tests that were medically unnecessary. It has to be one or the other but it cannot be both. What legal action can I take against the hospital or the insurance company?