Virginia Insurance Policy Denials – What to Do

If you have an insurance policy based in Virginia and have been denied reimbursement for Lyme treatment, you have several options.

 

1. You can contact the Virginia State Corporation Commission, Bureau of Insurance, specifically the Office of the Managed Care Ombudsman.

 

It is best to call them first to be sure they can help you with your particular problem. They have recommended you not do a lot of paper work until you first contact them.

 

If you’d prefer to email them, their email address is listed below.

 

Phone:  877-310-6560 (toll free)

 

Email: [email protected]

 

Website with instructions and forms:

 

https://www.scc.virginia.gov/division/boi/webpages/boiombudman.asp

 

AND/OR…..

 

2. File a “quality of care” complaint with the VA Department of Health. You might want to ask why your insurance company is basing their decisions on IDSA Guidelines that have been found to be developed during a corrupt process.

 

Website: https://www.vdh.state.va.us/OLC/Complaint/

 

Phone- Toll Free: 1-800-955-1819 or

Metro Richmond area: (804) 367-2106 

 

Email: [email protected]

 

 

NOTE- Insurers will often deny patients with Lyme disease all but the bare minimum and some have been known to flag the incoming claims which mention Lyme disease for that reason. Some will not review your case until an appeal is filed and they count on many people not bothering to file an appeal, in turn, saving them money.

 

So NEVER let it drop when you are denied. Fight for your rights! And make it easier on yourself by getting help from the above agencies. Some of them have been very helpful and surprisingly, some are very Lyme literate.