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Case Study: Harbor Health Care

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Ms. Allen signed up for insurance through Harbor Health in Michigan because no referrals were needed. However, when she called a physician (name unknown) she was informed the services needed to be approved. Based on the facility and treatment codes, Ms. Allen feels she should have been approved; however, Harbor Health decided to not approve the services. On, 2/16/2016, Malytha Williams, Healthcare Regulatory Liaison – Exchange called to follow up on Case #11802 and spoke to Ms. Allen’s sister, Mary Ann Brenan. Ms. Brenan identified herself as Ms. Allen’s Power of Attorney and expressed that she was considering dropping Harbor Health. She explained, that no one from Harbor Health contacted her and was still pending a response about a Prior

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