Often it can be difficult to sort through the complex rules of claims payments. There are many free resources for assistance, if you want to work through claims issues by yourself. Below are some resources in California.
Health Insurance Counseling and Advocacy Program (HICAP)
Health Insurance Counseling and Advocacy Program (HICAP) – HICAP is the primary local source for accurate and objective information and assistance with Medicare benefits, prescription drug plans and health plans. California HICAP is part of a national network of State Health Insurance and Assistance Programs (SHIP). HICAP provides free community education and unbiased confidential individual counseling statewide. HICAP Counselors are trained to assist you with choosing and/or enrolling in Prescription Drug Plans and Medicare Health Plans, filing original Medicare and private insurance claims and/or preparing Medicare appeals.
In Los Angeles, the local HICAP resource is: http://cahealthadvocates.org/HICAP/losangeles.html
Office of the Patient Advocate
The Office of the Patient Advocate is a State of California Agency which coordinates, provides assistance to, and collects data from state health care consumer assistance call centers. They also publish a Quality Report Card for health plans and providers.