Dr. Tiffany Najberg’s Shreveport UrgentEMS clinic has been underneath monetary pressure since Najberg got here out as transgender and adjusted her first title. She says a number of insurance coverage corporations refused to reimburse her for affected person care and the clinic is dealing with potential closure.
Since her title change in 2021, Najberg has misplaced an estimated $150,000 in funds from insurance coverage corporations Humana, Cigna and CVS-owned Aetna. On Saturday, Jan. 7 Najberg created a petition on the Change.org web site to name them out and on the time of publication has amassed over 4,300 signatures.
Now, representatives from the insurance coverage corporations have made contact with Najberg and her authorized workforce to barter phrases.
Learn the unique story right here:Transgender Louisiana physician says she was denied insurance coverage funds as a result of title change
Aetna offered the next assertion to The Instances:
“At Aetna, we worth our relationship with our suppliers and attempt to resolve any points they might expertise as shortly as potential.”
Najberg’s forensic billing professional English Perez reached out stating they’ve spoken with representatives from Aetna who clarified the claims that have been denied have been as a result of title on the declare not matching their databases.
“This was coping with 2021 and 2022 claims which had been submitted as clear claims for out-of-network processing,” mentioned Perez. We reviewed a number of claims and verified the supplier was/is Dr. Tiffany Najberg and the NPI and Tax ID have been a match. I requested all claims that have been denied to be reprocessed and expedited for fee. I reminded the consultant when the declare is reprocessed and paid based on the Public Well being Emergency pointers, curiosity on the declare would even be due. I prompt the Aetna claims and processing groups have coaching in range and inclusion as a result of the failure to pay claims upon a reputation change is inexcusable and damaging conduct.”
Humana additionally reached out.
“Celebrating various backgrounds and creating an setting of inclusion is on the coronary heart of Humana. We even have a powerful and longtime dedication to the state of Louisiana and the members and suppliers we serve all through the state,” a consultant of the corporate mentioned in a press release. “We have now regarded into this matter and found that the contract on file has a unique supplier title (physician and enterprise) and requires further data to course of the claims. We’re expediting a brand new contract with the supplier in order that the claims could also be processed.”
Along with the negotiations going ahead to obtain compensation, she got here into the clinic this morning to seek out an nameless donor had left a verify for $5,000 to cowl the overdue lease. With this cash, UrgentEMS will have the ability to maintain its doorways open for an additional month whereas Najberg waits for the compensation from the insurance coverage corporations to come back in.
“My objective is not to only mindlessly assault them, I merely need truthful reimbursement for providers rendered,” Najberg defined. “I used my life financial savings to cowl what they did not give me. I imply, $150,000 shouldn’t be a tiny sum of money. The opposite factor is that this combat has implications which can be far wider. This is not simply me wanting to handle a private grievance, I additionally don’t desire this taking place to others.”
On the time of the publication, Cigna has not responded to a request for remark.
Meredith G. White is the humanities and tradition reporter for the Shreveport Instances. You will discover her on Fb as Meredith G. White, on Instagram and Twitter as @meredithgwhite, and e mail her at mgwhite@gannett.com.