I am having a really hard time getting claims paid to out of Area HMO's. These are usually patients that come in with Medi-Cal and then it is discovered later that they had a private HMO insurance that is out of the area, or in the area. My issue is the HMO denies to health plan and the health plan denies to HMO. Any ideas or resources on how I can get past these road blocks. The other issue I frequently run into are claims that are paid by Medi-Cal, the money is taken back and the patient belongs to an HMO. Any input, ideas, or help would be greatly appreciated. Thanks in advance!