You might want to contact the attorney generals office in your state and explain the situation. They are attempting to defraud the insurance company. Your agreement with the company is a contrat which you can enforce. The insurance company is bound to pay for 30 days treatment per your contract with them.
If necessary you may be able to sue the treatment facility for negligent misrepresentation to get your $16,000. My guess once an investigation is started thet will find many more cases of misconduct. .
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Since I am from Oklahoma and the services were in California, can I take legal action with a attorney in Oklahoma? Remember, a individual came from California to Oklahoma to take her back to California.
You will need a California attorney is you are suing the hospital. You might be able to get away with an Oklahoma court, but picking up the patient in Oklahoma may not be sufficient for Oklahoma to have jurisdictiion. In any case, the hospital could probaby have the case moved to California.
I was going to resubmit the paperwork from the facility to my insurance company with a copy of my canceled check with a explanation. My main concern right now is to get a refund from my insurance that should be covered by my insurance. Do you think that this will be ok?
I am afraid that if I have to get a attorney from California with travel expenses, it will be more than I can afford; therefore, I was going to turn them into the board of California to investigate the facility and hopefully get their license taken away. I spent my life savings to get my daughter help and they falsely represented their services.
If the case was trialable in Oklahoma, I had a attorney that would work on continency. My main goal is to get my percentage back from my insurance and cause them a great amount of grief. I do not want another family to get taken like myself.
If you have a pro bono attorney he can better guage what the realtionship of the hospital to Oklahoma is. In order to sue in Oklahoma te hospital has to have a relatinship with activity in the state.
Since you are only asking for the "reduced" amount as reimbursement you should not have a problem. You should turn them in the state and let the state handle the apparent fraud. I would also contact the state attorney generals office cosumer affairs and explain the situation.
You should be able to do a screen print. To be safe I would cut and paste each ection into a worpad, or wordprocessor. You have already contacted the insurer, I am surprised that their loss mitigation department is getting right on the fraudulent billing.
Attorney
OH/TX Practicing Attorney focusing on Family Law, Foreclosure, Landlord-Tenant Issues.