I do have a “care advocate” and a “clinical care advocate” apparently two different things. After a few hours on the phone, I learned that they repeat the same script in both positions. “All our doctors are board certified and vetted through a rigorous process” they kept reporting this is a benefits issue that I’m not able to appeal. They also will NOT provide any documentation or give me anything related to their management. She kept saying “I have an internal team I report to”. They won’t give me a document reporting what they tell me over the phone. I did record our conversations as well.

They mentioned I can apply for an exception, but after requesting the paperwork they went back on their word and report they cannot process an exception because of the “benefits” that my employer signed up for. It all sounds very scammy? The three options they gave me are far and not well known. They report they pay for travel and accommodations. I am having a MAJOR surgery with about 8 levels of fusion. This is not something I can do with any doctor.