medical insurance
My pediatrician&#39;s office refuses to call for an authorization code (NJ) for pediatric bloodwork
<p>My son is 3.5 years old and has autism - he has a script for bloodwork from pediatrician. The location I found specializes in children with special needs (out of network)/ (he has been to this hospital but not this dept.) insurance -  NJ Horizon Health / medicaid. The office requires an authorization code to see my son - CAN HIS PEDIATRICIAN REFUSE THIS?</p>
<p>Why can't I try to give him to the best possible care? He may be denied but he may also be able to get the service. Can she refuse to call for authorization?</p>
<p>They want name to go to the unprofessional Labcorp (local) and when I called they don't even have a tech that works with pediatric blood drawing! please any and all  info welcome.</p>

<p>There is a federal law, the <a href="https://en.wikipedia.org/wiki/Emergency_Medical_Treatment_and_Active_Labor_Act" rel="nofollow noreferrer">Emergency Medical Treatment and Active Labor Act</a> which legally compels an emergency room (provided that they accept Medicare payments) to provide a medical screening examination and stabilize the patient. This is outside the scope of your concern. Otherwise, doctors have the same right to refuse to serve a customer that anyone other business has. Typically, when a business has good reason to believe that a person will breach their contract by not paying for a product or service, they have the right to refuse service. Authorization codes exists to remove the guesswork: it indicates that the insurance carrier has refused to cover some treatment.</p>
<p>Whether or not the insurance company can legally refuse to pay for a certain treatment, or stipulate what providers can provide the treatment, depends on the contract you have with the insurance provider.</p>
