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						February 14, 2000

 

 


VIA E-MAIL AND U.S. MAIL

R. James Martin

	RE:	Intracorp and Dr. Greenhood

Dear Mr. Martin:

This is a follow-up to the E-mail message you received from me regarding your E-mail to Kirk Rothrock, Intracorp’s President, and Allen Woolf, M.D., Intracorp’s medical director.

Following review of the file in this case, I must advise you that Intracorp is not able to offer you another review or appeal in your case, since as you know, the final appeal was completed with the response you received from Linda M. Farina, Senior Director, Employee Benefits at Metromedia Restaurant Group. Under the terms of your benefit plan, that was the final appeal afforded to you.

The difficulty in obtaining records related to your case was due to the fact that Dr. Greenhood did not review your case in the context of an appeal of an Intracorp denial of medical services. Under the terms of your benefit plan, your appeal recourse was through First Health and Metromedia. The extent of Intracorp’s involvement was to provide an external review of this case, as part of Metromedia’s final appeal process, via our Physician Consultation Service. Since you referred to the review as an appeal, the records could not be located because records for appeals are stored separately from Physician Consultation Service records.

Again, when you wrote to Intracorp, unfortunately, you did not inform us that you had already received your final appeal and final determination in this matter. In light of this information, Intracorp is not able to offer you another review. Should you have any questions concerning this correspondence, please contact me.

						Sincerely,

 

						Marsha M. Silberstein, M.D.

MMS/vkc

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