Sedgwick Claims Management Services

Sedgwick CMS refused to cover ongoing treatment of an ankle injury I had sustained at Reyes Holdings LLC. My claims examiner, Cherie Passarella, was almost never available to talk and so I had to communicate with her supervisor, Kasey Weber for most of the time. Kasey said I could go to to any provider of my choice after I go to my initial care provider, Med Center 100. Then a few weeks later she said I have to be evaluated by an orthopedist and that I have to use their panel of orthos. However Cherie had said earlier that all she needed to agree to pay for treatment was the dictated notes from Med Center 100, and that I could continue treatment on my own as long as I present my private insurance in case she denies payment. Additionally, the ortho on the panel Kasey gave me was only for fractures, which I didn’t have. Kasey later said she needed notes from the ortho I was seeing on my own, which was Wissahickon Orthopedics. I gave her the contact info to get the notes and she ends up never requesting them. She also falsely stated that my 90 day probation period started over when my claim was re-opened, which is why I couldn’t see doctors of my choice. Kasey then reveals to me that I had to go to Med Center 100 per the 90 day rule, though I was past 90 days at that point. Kasey ends up finally authorizing me to go to Wissahickon Ortho. After more frustration from me, she states she’s not my examiner and can’t handle my claim; though she was the one handling it for three weeks. She also states she hadn’t requested any notes from anyone, and that Med Center 100 was the only provider I had been authorized to see, even though she literally authorized me to go to Wissahickon. Cherie finally gets back to me and states I can go anywhere since I’m past 90 days. So I was sent to Med Center 100 for no reason. Cherie then states “Kasey is my supervisor and she doesn’t fully understand PA WC case law. She was just trying to help me while I was out of the office.”

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