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Health Coverage Confuses N.Y. Consumers

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NU Online News Service, Jan. 21, 3:23 p.m. – The New York state attorney general’s Health Care Helpline handled almost 3,500 calls between Jan. 1, 2001, and June 30, 2002, according to a report from the attorney general’s office.

One-quarter of the callers asked about getting and keeping health coverage, but 72% had problems with existing coverage, the attorney general’s office says.

Twenty percent of all complaints arose from health plan mistakes in processing or paying claims, and 23% arose from health plan denials of coverage for care.

Utilization reviews that resulted in denials of care and coverage by health plans accounted for 11% of the complaints.

“Many consumers who call the Helpline are confused–about their benefits, about the rules to follow to secure coverage for care, about doctor or hospital charges, about appeal rights or about where to get help with some other aspect of health care,” officials write in the helpline report.