What is the name of your state? Services was in California, but the primary plan is in Maryland.
I have a grandfather PPO plan from Carefirst of Maryland.
I reached my out of pocket limit for the year.
I had 911 ambulance service from Los Angeles Fire Department. I was billed $2,745 by the LAFD.
Insurance only reimbursed me 907.40. saying they are applying out of network limits.
I appealed that decision. My appeal was denied. ( I claimed that out of network pricing does not apply to 911 emergency ambulance services.)
In addition, the insurance carrier did not provide a decision within the required 60 days.
I processed a complaint with the Maryland state Insurance Dept & Attorney General .
what do I do next?
do I file a lawsuit here in California since this is where I live and where the services was done?
I have a grandfather PPO plan from Carefirst of Maryland.
I reached my out of pocket limit for the year.
I had 911 ambulance service from Los Angeles Fire Department. I was billed $2,745 by the LAFD.
Insurance only reimbursed me 907.40. saying they are applying out of network limits.
I appealed that decision. My appeal was denied. ( I claimed that out of network pricing does not apply to 911 emergency ambulance services.)
In addition, the insurance carrier did not provide a decision within the required 60 days.
I processed a complaint with the Maryland state Insurance Dept & Attorney General .
what do I do next?
do I file a lawsuit here in California since this is where I live and where the services was done?