1 result for (book:tps7 AND heading:"delet session decemb 15 1983" AND stemmed:claim)
[... 1 paragraph ...]
(This morning at about 11:15 I got a call from a girl in the billing department at the hospital. She told me that Blue Cross has turned down the major medical claim for Jane, to their surprise. I was surprised and not surprised, mostly not, I guess. The girl sounded embarrassed to tell me the news. I said I’d see Andrew Fife after 2:30 this afternoon. The girl said something about Jane and “skilled nursing care,” but I didn’t really understand her, and let that go. At once I thought of an appeal through Pete Harpending, of course, and a possible lawsuit.
[... 5 paragraphs ...]
(He told me that such a turndown was the first time he’d seen it happen, and couldn’t understand it. He tried to explain about Jane’s care, but I only partially understood. The insurance company told him, I believe, that according to her medical records, Jane didn’t need to be hospitalized—a strange attitude, and one neither of us could believe. He suggested I see Pete Harpending, our lawyer, right away, saying that we have a good case. I got from him the name of the supervisior of claims at Blue Cross, as well as a person, Mary Krebs, head of Utilization Review, which determines what level of care a patient is at, at the hospital.
[... 26 paragraphs ...]