
What are out-of-network medical fees?
Out-of-network medical fees are incurred when you use an out-of-network medical provider, or one who has not been pre-authorized by your insurer. You may use an out-of-network provider because of their proximity in an emergency, or because of the specialized services they provide.
Generally, your insurer will still pay out benefits for out-of-network medical fees, though the benefits will be less, and you will have to pay a higher percentage of the costs. If your insurer underestimates the UCR fees involved with an out-of-network fee, the policyholder (you) will be left with a hefty bill.
Be Aware of Your Out-of-Network Medical Fees
To protect yourself from these types of medical claim overcharges, you should know what your medical plan covers. Most plans offer out-of-network emergency coverage, though you may have to explain to your insurer why you chose that type of care.
The difficulty comes when your insurer estimates the local UCR rates, as the methods they use to do this have come under scrutiny. If you feel you have been a victim of medical claim overcharges, you may want consider the possibility of a Massachusetts class action lawsuit, particularly if you believe that other policyholders were subject to similar claim overcharges.
Fighting Your UCR Rate Reductions
To protect yourself against an insurer's abuse, you have the right to take legal action. And because UCR rate reductions are an industry-wide practice, a Massachusetts class action lawsuit may be the best way to fight your case. A class action lawsuit will align you with people who have suffered the same type of abuse. Though your case may originate in Massachusetts, victims from all over the country would be able to join the class, thereby strengthening your case.
As a large group of plaintiffs, you will have more of a chance of building a winning case. To find out more about your legal options, you can contact a Massachusetts class action attorney who has experience with insurance claim denials and reductions. An attorney will investigate your claim, and if you have a valid case, help you to recover the money that you deserve.
The attorneys at Phillips & Garcia will fight for your rights in your health insurance class action lawsuit. We are committed to protecting your best interests and helping you collect the damages you need and deserve to move on with your life. If you have been treated unfairly or been a victim of unethical insurance billing practices, contact Phillips & Garcia today to schedule your FREE legal consultation - (877) 892-5620.
Let our legal experts review your case, and we'll help you obtain the compensation you deserve. Begin your case review by filling out the form below:
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