Decision Maker Response
Total Health Care’s response
Jan 27, 2014 — Dear Mr. Oberg:
We would first like to share that our thoughts and prayers are with your mother and her family during this difficult time. The unfortunate circumstances under which you were informed that services were denied are unclear, as they did not originate from Total Health Care. As stated in recent discussions with you, we want to emphasize that Total Health Care has NOT DENIED OR DELAYED TREATMENT for your mother.
Because this is a public venue, we are not able to discuss specifics regarding your mother’s care, as this would violate her privacy rights. We have spoken with providers involved in her care who confirm that they have no record of denied or delayed care for your mother by Total Health Care. Our process for issuing denials is to send written notification to the member and provider involved, along with a reason for the denial and their appeal rights. This notice was not sent because care was not denied. We want to assure you that the care of our members is our top priority. To that end, we would like to offer a nurse care navigator to assist you with coordinating care for your mother.
At Total Health Care, we make every effort to coordinate and facilitate the best care available with our talented network of providers. We have been a long-standing Managed Care Organization in the community, one of the oldest in metro-Detroit. Our goal is to continue to deliver on our promise of being “Totally There” for our members.
All the best,
Total Health Care