Tiffany Najberg, a Louisiana doctor who is transgender, said three insurance companies have refused to reimburse her since she legally changed her name nearly two years ago.
Companies have since struck deals with her and her Shreveport clinic, UrgentEMS, but not until after she started a request which garnered nearly 12,000 signatures and received media attention on its cause, including inquiries from NBC News.
Although all three insurers have agreed to update her name on their records and pay the claims, Najberg and her clinic have yet to receive any checks. Meanwhile, she has spent her life savings of about $200,000 to maintain her clinic, where she provides primary and urgent care, including to more than 100 transgender patients, some of whom hail from Alabama and Tennessee, two states that have passed. Restrictions on gender-affirming health care for minors.
After Najberg changed his name in April 2021, he said, he updated it with all the necessary government offices and with databases from which most insurance companies pull provider information.
She said that Medicare, Medicaid, Blue Cross Blue Shield and United updated the information and continued to reimburse her for the care she provided to her patients. But she said Aetna, Cigna and Humana had repeatedly denied her claims and refused to reimburse her.
“They were flagging each claim and rejecting it due to a name mismatch with their internal database. They didn’t change my dead name,” he said, referring to the name he used before his transition.
She said the three companies told her they don’t get information from the same database used by the government, Blue Cross and United. When she asked what database they were using in order to take the necessary steps to update it, she said they wouldn’t tell her what it was. Even after her office sent the companies the court order granting her name change and copies of her updated IDs, they still didn’t update her name, she said.
Last March, Najberg began posting videos about the refund denials to his TikTok account, where he has more than 150,000 followers. Last month, he also started a petition demanding that the three companies change his name and pay all back claims, something he said he did «out of desperation because nothing else worked.»
“I’ve spent every penny I’ve had,” Najberg said. “I don’t have three to seven years for a court fight. I have to earn a living now. I have hundreds of patients, and most of them are from vulnerable populations. I want to continue taking care of them.»
Najberg said the situation has also had an impact on his mental health, because whenever he contacted the three companies, their representatives used his dead name, which was still in their databases at the time.
English Perez, who since 1998 has done medical accreditations, including helping hundreds of medical providers update their credentials following a name change after marriage or divorce, or an error in their name, said it had never been found with a problem like the one Najberg has been facing. .
“That’s why I offered to help her,” Perez said, adding that she came across Najberg’s story on TikTok. “This must end for her, for the next person who becomes hers true self and lives in hers true self; They should never have to incur this kind of shame.»
Perez added that the relevant medical identification numbers and Najberg’s tax identification number reflect his legal name change.
“That’s why I said it’s more about the transition, less about a name change,” Pérez speculated.
In mid-January, after Najberg’s petition received more than 10,000 signatures and his story was covered by local mediathe three companies contacted but did not immediately agree to pay the back claims, he said.
Effective January 23, Aetna created a new contract with Najberg and agreed to process all back claims. Humana and Cigna had not agreed to anything at the time, she said.
NBC News reached out to all three companies on Jan. 24 for comment on Najberg’s reimbursement denials, their processes for updating medical provider names in their systems, and Najberg’s allegations that company representatives misrepresented her. repeatedly. All three responded the next day, though none responded to specific questions about Najberg’s allegations.
An Aetna spokesperson said: «We value our relationship with our providers and strive to resolve any issues they may experience as quickly as possible.»
The Cigna spokesperson said the name changes “have no impact on our payments to physicians or other health care providers; and we are committed to fair and timely payment for in-network and out-of-network doctors.”
Humana shared its first official response on January 27, with a spokesperson telling NBC News in an email that «we are pleased to have Dr. Tiffany Najberg as a provider in Humana’s network, and we look forward to continuing to partner with her and his office.
The day before, Humana had informed Najberg that the company would pay all past-due claims with interest and create an updated contract effective immediately that would place her in its network.
On Monday, Jan. 30, Najberg said that Cigna tentatively agreed to her terms and that she and her clinic now have agreements with all three insurance companies.
Noting that two of the three insurance companies didn’t help Najberg find a solution until they received an inquiry from NBC News, Perez said, «We can’t just sit back and breathe until those checks start coming.»
Little data is available on how many openly transgender medical providers there are and whether others have had problems similar to Najberg’s. Of 15,794 medical students entering surveyed by the Association of American Medical Colleges Last year, 1.4% reported that their gender identity is different from the sex assigned at birth, up from 1.2% in 2021 and 0.8% in 2020.
Najberg said he hasn’t had to stop seeing any patients as a result of the three companies denying claims for nearly two years, but his practice has had to postpone plans to expand its telehealth services to Texas, Mississippi, Alabama and Florida. because she can’t afford malpractice insurance in those states right now. She said that she has received more than 100 requests from residents in those states regarding telehealth care.
He said he’s been living off Go Fund Me fundraisers for about eight months and if he doesn’t start receiving reimbursements from insurance companies soon, he could lose both his business and his home. She has dropped her medical and dental insurance and eliminated all non-essential medications.
«I’m literally in survival mode right now,» he said.
She said her goal is not to attack any of the insurance companies, but to draw attention to what happened so it doesn’t happen again.
«I’m not asking for anything special,» he said. «I just want to be an equal.»