Fustrated with insurance company, where to file a complaint?

[Guest guest]

I am really upset with my insurance company right now. got a sinus

infection which started dripping down into her lungs and further setting off

her asthma and we know from past history it will lead to pnuemonia so the

pedi ordered Biaxin which is our usual treatment since its the only one that

seems to work (she's allergic to most other abx). Anyway the insurance

company is really ticking me off, anytime the Dr orders something for an

infection they want proof its not to treat the PID. She's been on the phone

arguing with them and I guess it got pretty heated and she's thinking of

refusing to take them anymore and make patients who want to keep her switch

to Health Net, personally I can't stand the amout of bull our insurance

(state funded) pulls but if she stops taking them were in trouble. Health

Net is not contracted with the childrens hospital and will ship us down to

UCLA. Its a great hospital yes but traffic is HELL, its a 3 hr drive there

and 4-6 hours back since we usually get caught in rush hour traffic (rush

hour seems to last from 3-8pm in LA) and I HATE HATE HATE going to LA. CCS

picks up most of my 2 yr olds care and sends her to Valley Childrens and I

set up there appts for the same day so its done in 1 trip and becasue the

baby is getting seen I get reimbursed, if were forced to switch to UCLA that

won't happen so we'd be facing more drive time, more appts and I can't

afford the gas money period, I also hate the fact that our appts at UCLA

seem to take an average of 7 hours with 95% of that waiting time, up at

childrens were usually in and out within 1 hr except for pulmo which is 2-3

hours. We also usually have a room at the Mc House at Childrens

which is a 5 minute walk so were not stuck driving 6 hours round trip in a

day. No such luck at UCLA.

Anyway, insurance company took almost 3 weeks to approve the Biaxin, we

waited a couple of days for the tar to come back and it was still pending

and she was just getting worse. So I decided to not pay the gas bill and

paid for 5 days worth assuming it would be back by then, it wasn't so I

didn't pay the Electric either and got another 5 days worth. Well almost 3

weeks later we have approval. Had we waited she would have had pnuemonina by

now and STILL couldn't treat becasue we also use Biaxin for that. This is

rediclious! To intentionally withhold critical antibotics from a PID patient

becasue becasue you want PROOF its not to treat the PID? The PID CAUSED the

sinus infection! I just want to scream, they did the same thing when we

tried treating a fungal infection and wanted CCS deniles before they would

even consider it and CCS takes a couple weeks to deny stuff usually. I can

not afford to be paying for meds out of pocket period but I can't afford for

my insurance to pull this garbage, is there someone I can complain to about

it at the state level?