Lost my trust in them

Guarantee of payment or rather Guarantee of failure?

On 23 April my daughter was screaming in pain. We had the ambulance out to check her vital signs as she was complaining of chest pain. They said all her vital signs are normal but if they persist, we must take her to hospital.

She continued screaming, so we decided to take her to hospital. Before we went, both me and my husband phoned Get Savi Health to get authorization. They agreed that her symptoms seem to justify us taking her to the hospital and they sent a Guarantee of payment to us, after quite a struggle with the hospital emergency staff who was unfami**** with this insurance. The hospital made us wait in the waiting room with a screaming child as they did not know the name of insurance.

Luckily my daughter only had reflux and constipation and her high heart rate was due to pain and anxiety.

Now more than two months later they claim that they will not pay any of the accounts as it was not a medical emergency, due to the diagnosis.

So I just wish to know how I am to determine whether a person with chest pain has a serious medical emergency or not before a doctor makes a diagnosis? Do I just leave the child with a high heart rate and complaints of chest pain to cry because GetSavvi Health only pays once a medical emergency has been confirmed?

The same case manager who gave me the Guarantee of payment, now refuses to pay the accounts and just says he cannot tell me why it is like this, it just is and each case is different. So how do they determine when it justifies payment of not?

How does anyone know whether something is an emergency or not if you do not have a medical degree or any training in medicine?

How can I as a client of GetSavvi Health make an informed decision about taking my child to the emergency room or not? I honestly lost my trust in them after being a loyal client for many years!