By adamg on Thu, 10/17/2013 - 4:24pm
Louis Gudema posts a copy of a letter to the CEO of Harvard Pilgrim, which is refusing to pay more than half the cost of an emergency eye procedure even though an eye specialist at Harvard Vanguard told him he needed to get to Mass. Eye and Ear right away or risk having his retina detach. Seems Harvard Pilgrim doesn't agree it was an emergency, and it doesn't pay for "routine" care at the infirmary.
Apparently, although I was told specifically to go to Mass Eye and Ear’s emergency room by Harvard Vanguard, I was expected to check with Harvard Pilgrim at 2AM on a Sunday morning to see what was and was not covered there. Even if I had tried check with Harvard Pilgrim at 2AM on a Sunday, your website does not list a weekend or emergency number. How could I have gotten an approval?