Insurers Refuse to Reimburse Trans Doctor Under Legal Name
Aetna, Cigna, and Humana accused of only paying out claims under doctor's "dead name," creating financial hardship for her practice.
A transgender doctor in Louisiana is facing financial hardship and may have to close due to insurance companies that have refused to reimburse her for patient care using her legal name.
Dr. Tiffany Najberg, who owns UrgentEMS in Shreveport, Louisiana, says that even though she legally changed her name, insurance giants Cigna, Humana, and CVS-owned Aetna refused to pay out claims unless they are filed under her “dead name.”
Najberg’s name change, which was confirmed long before she opened her clinic in June 2021, has been accepted by various government agencies, including the Louisiana Department of Motor Vehicles and the U.S. Social Security Administration, as well as various medical boards and regulatory agencies, her residency program, her medical school, the Medicare Provider Enrollment, Chain and Ownership System, and insurers like Blue Cross and United Healthcare.
However, Cigna, Humana and Aetna refused to acknowledge her gender identity or new name, and insisted on issuing reimbursements under her previous name — meaning Najberg cannot recoup the money she’s owed without breaking the law.
“I immediately changed all of my professional qualifications by the end of June 2021 and that included not just things like my social security and driver’s license, but my medical license, my DEA number, my Louisiana State Board of Pharmacy number, databases that insurance companies draw from,” Najberg told the Shreveport Times.
“Some of the insurance companies decided that they weren’t going to honor my name change and they were just going to use my dead name,” she noted. “Since I can’t legally practice any medicine or medical care underneath my dead name as that would be fraud and impersonating and a felony. They’re using that as an excuse to just not pay because according to them I’m not a person.”
Najberg also notes that name changes are not uncommon in the medical field.
“Cis women get married all the time and some of them are even doctors and insurance companies don’t get away with saying ‘we’re not going to pay for a year and a half’ because you got married, right?” she said. “What they’re doing in my case is clearly discriminatory.”
Najberg was also forced to relocate her clinic in December 2021, just six months after opening, due to a malfunction that led her office to lose air conditioning for an extended period of time during the hot Louisiana summer, which caused some of the medical supplies to melt and forced her to postpone seeing patients in person due to the extreme temperatures. That relocation had already put the clinic into financial hardship, which was subsequently exacerbated by the refusal of the insurance companies to reimburse her under her legal name.
Najberg estimates she’s lost about $150,000 in payments from Cigna, Humana, and Aetna, and has created a GoFundMe page in which she has promised donors certain prizes or benefits for varying donation amounts. For instance, any person who contributes $50 will have their name listed o the clinic’s website, while a donation of $250 gets the donor a 15-second shoutout video on Najberg’s popular TikTok page, and a donation of $1,000 gets the donor a 30-minute Zoom call to discuss any medical matters with Najberg, free of charge.
Earlier this month, Najberg created a petition on Change.org calling out the insurance companies for discriminating against her. The petition, which has garnered more than 6,900 signatures, also urges signers to contact the insurers via phone and complain about their anti-transgender stance.
Najberg also filed a complaint to the Louisiana State insurance commissioner’s office and has acquired a forensic billing expert and a lawyer to help her navigate the financial difficulties caused by the insurers’ refusal to acknowledge her name change.
On Jan. 11, Najberg posted an update to her TikTok channel, in which she noted that representatives from Aetna had reached out to her forensic billing expert and have agreed to reprocess all of the claims and reimburse her, with interest. Aetna also reportedly promised to issue a letter of apology to Najberg and to require employees to take diversity and inclusion training.
“At Aetna, we value our relationship with our providers and strive to resolve any issues they may experience as quickly as possible,” the company told the Shreveport Times in a statement.
Najberg’s forensic billing expert, English Perez, told the Times they had spoken with Aetna representatives and confirmed that the claims were denied due to Najberg’s name not matching the name listed in the company’s database.
Since the initial article regarding the reimbursement denial, Humana has also reached out and is in the process of negotiating with Najberg to ensure she’s reimbursed for services rendered.
“Celebrating diverse backgrounds and creating an environment of inclusion is at the heart of Humana. We also have a strong and longtime commitment to the state of Louisiana and the members and providers we serve throughout the state,” a company representative said in a statement. “We have looked into this matter and discovered that the contract on file has a different provider name (doctor and business) and requires additional information to process the claims. We are expediting a new contract with the provider so that the claims may be processed.”
The Times previously reported that Cigna claimed to be working on a statement to respond to Najberg’s claims, but the company did not respond to a subsequent request for comment.
Najberg recently received some positive news after an anonymous donor left a check for $5,000 at the clinic to help her cover overdue rent payments. With that money, UrgentEMS will be able to stay open for another month while Najberg tries to negotiate with the insurance companies.
Najberg continues to encourage her followers to keep up the pressure on the insurance companies so they will do the right thing. However, she has noted in subsequent videos that only 5% of her TikTok followers have signed the petition, putting her well behind her goal of reaching 10,000 signatures.
“I simply want fair reimbursement for services rendered,” she told the Times in a follow-up interview. “I used my life savings to cover what they didn’t give me. I mean, $150,000 is not a tiny amount of money. The other thing is this fight has implications that are far wider. This isn’t just me wanting to address a personal grievance, I also don’t want this happening to others.”
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