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Colorado Health Care Law Questions & Answers
1 Answer | Asked in Health Care Law and Insurance Defense for Colorado on
Q: My insurance company declined to pay my hospital bill on the grounds that I should have been treated as an outpatient.I

I had a skin infection on my hand from a cat bite.

I asked to be treated as an outpatient but the doctor refused saying I had to be admitted.

I haven't got the bill yet but I expect to get one soon.

The insurance company says the hospital handled this the wrong way.

What am I suppose to do?

Tristan Kenyon Schultz
Tristan Kenyon Schultz
answered on Jan 18, 2017

You have three options. One, you can appeal the insurance company's determination. Two, you can see if the insurance company's determination voids some or all of the medical charges because of the violation of the agreement between the doctor/hospital (I have seen over $200,000 worth of... Read more »

1 Answer | Asked in Health Care Law for Colorado on
Q: Can an emergency room visit for panic attacks and withdrawal be subpoenaed without patient consent?

On probation for a dwai last year. Recently went to emergency room to assist in final leg of self-imposed withdrawals (from a substance not scheduled or controlled, but which could likely constitute prob violation against using "abusable" drugs - Tianeptine) and associated panic attack.... Read more »

Tristan Kenyon Schultz
Tristan Kenyon Schultz
answered on Dec 21, 2016

As a condition of parole, the general rule is that parolees cannot prevent the release of limited amounts of relevant medical records on request (often tied to the type of offense). The ER visit (with documentation) should be ok with your parole officer, as for Tianeptine this is a grey area. Since... Read more »

1 Answer | Asked in Divorce and Health Care Law for Colorado on
Q: How soon after a divorce can my kids and I receive Medicaid?

My husband makes a good living, but I am a stay at home mom and will need health care. I don't want to leave any lag time so that I get charged the fine.

Tristan Kenyon Schultz
Tristan Kenyon Schultz
answered on Oct 3, 2016

Healthcare should be covered under the separation agreement and custody agreement. For the minors it is totally reasonable to request that the father pay for their healthcare costs (esp. if he is historically the breadwinner--this request will likely reduce potential alimony requests). For you,... Read more »

1 Answer | Asked in Health Care Law and Consumer Law for Colorado on
Q: Dental Insurance - Are there any remedies for work done before the waiting period?

Husband had dental work done prior to his 6 month waiting period. No one at the office had told him that he had this waiting period (understandably, we have the duty to read all fine print). However, I went to my own dentist and they notified me immediately of my waiting period and wouldnt... Read more »

Tristan Kenyon Schultz
Tristan Kenyon Schultz
answered on Mar 3, 2016

From your facts is appears that your dental insurance company provided adequate notice to you and applicable dentists, so you likely do not have a claim against the insurance company. Turning to your husband's dentist, your situation is not a clear-cut case. Unless the dental agreement states... Read more »

1 Answer | Asked in Collections, Health Care Law and Consumer Law for Colorado on
Q: Had to take an ambulance ride. The ambulance company did not file the claim to the insurance company in their allotted

time frame so they say they will not pay. Now the ambulance company is expecting me to pay out of pocket. Am I responsible for this bill since it is their fault for not filing the claim in time?

Tristan Kenyon Schultz
Tristan Kenyon Schultz
answered on Feb 8, 2016

I' handling a similar matter like this today. There is not a clear rule on this matter and it partly depends on your insurance. As a general rule, your insurance carrier requires the ambulance company (like all medical billers) to follow certain procedures. If the biller (the ambulance... Read more »

1 Answer | Asked in Health Care Law for Colorado on
Q: A brother and sister are in therapy. The sister tells her therapist something about the brother and her therapist

Tells the brothers therapist. Is this not a breach of confidentiality

Tristan Kenyon Schultz
Tristan Kenyon Schultz
answered on Jan 27, 2016

It may be a violation. However, therapists are allowed/required to report certain information. The most common exception is if a crime of significant injury/harm is likely to occur. Lawyers have this exception too incidentally... If you feel the reporting was not justified you can file a complaint... Read more »

1 Answer | Asked in Health Care Law for Colorado on
Q: I need an attorney for Involuntary medication administration authority appeal

I am being blamed and forced to believe I do not make effective treatment decisions. please help.

Tristan Kenyon Schultz
Tristan Kenyon Schultz
answered on Nov 22, 2015

Has a court already held that you are incompetent? If it hasn't there will be a required hearing in which the party trying to find you incompetent will have to prove by clear and convincing evidence (a heightened standard) that you are incompetent. You should seek legal representation (either... Read more »

1 Answer | Asked in Health Care Law for Colorado on
Q: Am I legally bound to go to psychatric hospital if family member calls the cops?

My overbearing parents are determined to have me medicated for depression even though I refuse treatment. 7 months ago they called the cops and had me taken in to the hospital for a mental evaluation. I was released within an hour because I was not suicidal and did not have intentions of harming... Read more »

Tristan Kenyon Schultz
Tristan Kenyon Schultz
answered on Nov 1, 2015

From the US Constitution, an individual has a right to a judicial hearing before being involuntarily committed on an permanent basis. There is an exception that allows the state (i.e. police or social workers) to place a temporary hold (without a hearing) if there is a reasonable belief the... Read more »

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