Q: if I had emergency surgery under mass health and a claim was filed, can they cancel my policy and deny my claim?
I had emergency surgery and they filed a claim, 3 months later they canceled my policy due to not verifying my address and then sent me a letter requesting correct information for the claims filed and to help them figure out how the claims can be paid correctly? im trying to respond on their online questionnaire regarding the claim info and it won't accept my case ID #. is my claim still valid now that im without health insurance? I looked over my plans coverage and I was covered for the services they rendered.
I have a settlement coming up and the surgery was unrelated to my accident as they were 11 months apart. I fear they will deny my claim and put a lien on my settlement. please help. much thanks
A: Your matter is more complicated than one where a simple "yes" or "no" would do as a answer. The ideal situation would be that if your settlement is in connection with an accident where you are represented by an attorney, to have them look into the validity of the lien for an unrelated service. As a general rule (without speaking for state-specific policies) if medical procedures are related to the accident, a carrier's subrogation department will assert a lien. Additionally, as a general rule, public health insurers and other public entities will also assert liens even if they are unrelated to accidents (such as social services benefits). A Massachusetts attorney (hopefully yours, if one is representing you on the case you mention) experienced in handling cases involving health care liens should be able to advise in terms of your obligations here. Good luck
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