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HealthNow, New York Inc., will pay over $1.6 million in claims

HealthNow, New York Inc., will be paying claims it wrongfully denied for thousands of covered individuals. The announcement was made by Eric T. Schneiderman, New York’s attorney general. The wrongfully denied claims total over $1.6 million.

The attorney general reported that the company, for which about 573,700 people in New York rely on for health care coverage, improperly denied behavioral treatment claims. The company was supposed to have an authorization in place for the first 20 visits each for outpatient behavioral health. Instead, the attorney general said that the company wrongfully reviewed thousands of claims under that 20-visit threshold.

Those are not the only patients who were wrongfully denied claims, said the attorney general. Over 100 claims filed by those in need of nutritional counseling because of eating disorders were also denied and excluded from coverage.

The attorney general said “Insurers have a legal obligation to provide the same level of care to patients being treated for behavioral health conditions as they do for patients with other ailments. Individuals confronting mental health conditions, eating disorders or substance abuse should not be denied coverage for the treatment they need and deserve.”

Not only will Health Now be paying the wrongfully denied claims, the company will also pay the attorney general’s office a fine of $60,000.

The denial of a claim can have a drastic financial effect on someone who thought the claim should be covered. Now, he or she owes the amount of the claim, which could total in the thousands. If you believe your claim was wrongfully denied, you may learn about your legal options from an experienced attorney.

Source: Legal News Line, “HealthNow to pay members it allegedly wrongfully denied claims,” Aug. 26, 2016

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