My daughter was admitted to Sovereign Health for treatment in February. Although their promotional materials state clearly that they accept insurance, I was asked to pay by credit card in advance just two days before her flight was scheduled to leave. I was quoted, in writing, a treatment price of $15,000 per month plus an additional $500 for doctor and psychiatric initial exams and an outing fee.in total, I was asked for $26,541.98 over the course of my daughter's treatment.
I repeatedly asked for updates on the progress of insurance claims, which were to be filed with the benefit coming to me. I never received a response to those questions except that "they were working on it." By November of I still had never received confirmation that claims had been filed.
Eventually the claims were filed, but the amount was astronomically higher than the price I had been quoted for treatment. I received EOBs around the second of March. Sov. Health was reimbursed for $55,398, more than double what I was told was the cost of treatment.
In addition to reimbursements to Sov. Health, there were claims filed for staff members who were hired by Sov. Health and whose services I had been told were part of the treatment provided. I have made approximately ten phone calls since receiving the EOBs showing payment; I have provided written material clearly outlining what I was charged, what I paid, and demanding reimbursement. Today, July 4, I have received nothing.
I am told by the staff member who will occasionally speak to me that the Director won't approve the payment until every single charge has been verified and there are no questions. Then I am told I will have to sign a release form before I will receive any money.
I have had health insurance for approximately 45 years of my working life, and I have never experienced anything like this before. The math is pretty clear to me, and I am not an accountant. I paid, my insurance paid more than twice that, and now Sovereign Health seems intent on keeping all of it. That isn't a bad deal for them, $81,939.98 for treatment quoted as costing $26,500.
I would love to have some suggestions for proceeding to correct this kind of unscrupulous behavior. I live in Kentucky, so I thinking a local attorney would not be the best, but I am not sure how to locate one close to or in Orange County who would be able to handle this type of case.
When I do an internet search for medical, fraud, insurance, I never find anything like what has happened to me at Sovereign Health. The cases are almost always against the insurance company for refusing treatment. I am prepared to start an action plan and open to suggestions.
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