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Complaint 1 of 5 in "In Network / Out of Network Issues"

Insurance Carrier: Harrington-fiser Health
State: Arizona

Consumer Complaint:

I am a Retired Arizona State Employee. My husband and I first started going to Mayo Clinic in 2004. We both are Medicare Primary with Harrington-Fiserz as our secondary insurance. Harrington-Fiserz continues to under-pay our claims to Mayo Clinic, by deducting co-pays and Negotiated Discounts. Mayo Clinic Financial has told us that they charge 15% above the amount allowed by Medicare, and our insurance (Harrington-Fiserz) should pay the balance. They would allow a Negotiated Discount IF they had a contract, but Mayo Clinic does not have a contract, nor do they want any Healthcare contracts with Harrington-Fiserz or the State of Arizona. We have repeatedly notified Harrington-Fiserz of this fact, and sometimes they pay the disputed amount, but then continue to do it over and over again on other claims. It now is more than $1000 for each of us. Mayo has turned us over to an outside collection agency and is refusing to allow us to make appointments.


Insurance Expert Answer:

Fortunately you were accepted by Mayo in Scottsdale as patients -- it's the top of the heap. Unfortunately your health plan does not seem to have an arrangement with Mayo. You've tried to get them to join but they won't. There can be many reasons why. Get someone in AZ State government to try to help. The best bet is your local state senator or state representative. One of them may be able to help move the bureaucracy to sign up. Next year, if you have a choice of plans, choose another plan. In the meantime having to pay 15% over what Medicare pays is a BARGAIN. I suggest you pay it out of pocket.


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