How I got my money back from MGH and NHP

January 19, 2015
Member Services Center- Appeal Team
Neighborhood Health Plan
253 Summer Street
Boston, MA 02210-1120

Member Name: Gary G Johnson
ID Number: NHP1137944

Dear Sirs,

On March 21, 2013 I had a colonoscopy at MGH. I was subsequently billed $980.00 by MGH, because NHP did not cover the all the costs of my colonoscopy. According to my plan literature, you cover 100% of:

Primary Care for Preventive Services.
Screening Colonoscopys

A colonsocopy is a preventive service.

My primary care physician, Dr Sweet was notified of this. Her response was, I am shocked they did not cover the procedure. What do they want to do, pay for Cancer?

My feeling is that this is ‘Bait and Switch”. You advertise one thing, and then change the rules. When I chose NHP as my Health Care provider, I researched my plan. In my research, I found nothing to say that all costs for preventive care were not covered. I relied on this information. I want you to pay the full cost of my colonoscopy.


Gary Johnson