I am writing to formally file a medical grievance regarding a recent experience with Dr. Hussein Abdulhadi, a provider within your network. This grievance pertains to the mishandling of the insurance authorization process and the unprofessional conduct of the provider's office staff.
On May 21, 2025, I was scheduled for a consultation regarding back injections for chronic pain. Prior to the appointment, I requested that the provider confirm authorization for the treatment under my Blue Cross Anthem plan. Despite multiple phone calls and explicit requests to ensure prior authorization was obtained, the office staff repeatedly refused to verify coverage with Blue Cross Anthem. As a result, I was left facing a $95 out-of-pocket copay for a consultation that should have been pre-authorized, had the proper procedures been followed.
This failure to confirm treatment coverage not only imposed an unexpected financial burden but also caused unnecessary delay in my treatment, contributing to prolonged and avoidable pain. Furthermore, during my interactions with the office by phone, I encountered multiple instances of dismissive and unprofessional behavior. Staff members were unwilling to provide clear information or make any effort to assist in the insurance verification process. Their attitude left me feeling disrespected and disregarded as a patient, ultimately leading me to cancel my appointment the day before, as I felt I had no other reasonable option.
I believe this provider did not follow the appropriate standards for securing prior authorization and did not uphold the level of professionalism expected of an in-network provider. I respectfully request that your office review this matter, including the authorization handling and staff conduct, and consider any appropriate corrective actions. read more
