I jumped through every hoop below:
So did the doctor who needs a second opinion.
Denied by UCLA.
Then United Health Care
72 hour urgent appeals.
I made a CMS complaint.
First 30 days. no results.
Second one is at 21 days.
CMS turns it over to:
United Health Care Medicare Complaints team in NYC. Representative will not even call me back. Useless.
The whole system is broken.
Yet another United HC supervisor at NEC Found an appropriate Endocrinologist.
Turned away yesterday’s news by her assistant. I do not know what to do. I need to get to a doctor.
I can change by Dec. 1 st. as I have Medi-Medi and can change any month.
Do you know anything about Cedar-Sinai?
So far my case file from United health care, my right after an appeal, has been withheld. Because the appeal was put in by my Endchronologist, they will not send me anything. They work for Medicare supposedly.
In CA. Ucla as an HMO rules everything.
***Right. Maybe you would be better off with Original Medicare and just let Medi-Cal fill in the gaps? Then you might check out the UCLA CMS Medicare Shared Savings Program, a new care coordination program specifically for Medicare Fee-for-Service patients. It’s an Accountable Care Organizations (ACOs) are groups of doctors, hospitals, and other health care providers, who come together voluntarily to give coordinated high quality care to their Medicare patients. Learn More==> UCLA ACO
They all site passages from the material you sent me. Everything is about the rules and networks. Nothing address patient care, quality of care, or the fact that I needed the right doctor since UCLA,s Endo made a medication error in May, 2016.
That is how long this has been stalled and stalled. I will watch that video by the lawyer. Maybe that is what I need?
I did them all.
It appears that no agency has any real control over medical groups that are Medicare advantage plans.
***Then go back to original medicare and just let Medi-Cal fill in the gaps?
Maximus goes up to the federal justice system, in a 3 appeal process. With long waits between. If your really sick and need a higher level of care, it is useless.
I think I need a good lawyer.
***Try this page.
I have fraudulent bills for services never received. I think the only way to “blow the whistle” is for me to make direct complaints to the medical board about specific doctors. The real care at UCLA is not good enough, to many mistakes with no communication between doctors. All their hype and awards is BS.
When I get my health back I will start.
But if you know of a lawyer that is a health Care advocate, let me know please.
Thanks for all the great info,