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Identity

Trans doctor says major insurance companies are refusing to pay her after legal name change

"As long as they're denying my claims for my services on that ground, they can do that to any trans healthcare provider of any type."

insurance companies; trans rights; trans doctor; trans community
Courtesy of Dr. Tiffany Najberg

Insurance companies can withhold pay for trans doctors and one doctor is fighting back.

Insurance companies can be a frustrating maze for consumers and for providers. It's not uncommon to call the number on the back of your insurance card and get a different answer every time you call with the same question. But for Dr. Tiffany Najberg, the fight with the insurance companies is a bit more personal.

Najberg is a transgender woman who has run into a multitude of problems in the insurance claims world—not as a patient, but as a provider. After changing her name legally and updating all of the required information on official websites, including the Council for Affordable Quality Healthcare and the National Plan and Provider Enumeration System, two websites insurance companies look at to verify providers' credentials and ability to practice, her claims have been denied.

In the beginning of this year-long saga, Najberg was receiving checks, but the checks were in her dead name and couldn't be cashed. After going several rounds with the insurance companies, the checks stopped coming and the insurance companies started denying her claims altogether. Of course, this prompted even more questions and frustration since Najberg updated the insurance companies with her legal name as required.


Najberg told Upworthy that on six different occasions, she and her billing company attempted to rectify the situation to no avail. These aren't small companies that may have never encountered such a request. In fact, many Americans with insurance are likely covered by one of the companies she's currently challenging. "Human, Cigna and Aetna flat out refused, but Medicaid, BlueCross BlueShield changed it immediately so it clearly has been approved through national databases," Najberg said.

The insurance companies' refusal to pay has been hurting Najberg and her practice, UrgentEMS, located in Shreveport, Louisiana. "My clinic treats everyone, but we aim towards communities that are underinsured and uninsured. I don’t have money to pay my rent next month because of this," the doctor told Upworthy.

Najberg explained that between the three major insurance companies, she is currently owed nearly $200,000 in unpaid claims. Of course, she could turn patients who have these particular insurances away, but for Najberg, that's not an option because she focuses on serving those who are underinsured and people in marginalized communities. She currently has over 100 trans patients who need continued healthcare with someone who makes them feel safe.

During the height of the pandemic, her clinic served as a place where people could get COVID-19 treatment, with Najberg proudly saying she treated everyone across the political spectrum. Najberg has built such a reputation on TikTok for her openness and ability to present public health issues in a relatable way that CDC officials have contacted her for pointers on how to engage the public.

But none of that matters if she can't keep her doors open, and the fear that comes from recognizing that possibility keeps her up at night. Through tears, Najberg expressed her concerns for the most vulnerable population she treats, saying, "I'll likely have to sleep in my car, and what about my trans patients? If my clinic closes, a few of them may kill themselves."

Dr. Najberg runs a clinic in Shreveport, Louisiana.

Courtesy of Dr. Tiffany Najberg

Najberg actually found herself in the position to lose everything last month after once again not being paid, but thankfully someone anonymously paid the rent on her office space, which costs around $5,000 a month. Recently, she has relied on donations from her followers in order to keep her doors open until she wins her fight with the insurance companies.

During the interview, Najberg informed Upworthy that one insurance company is now complying. "Aetna has started processing all the back claims and a new contract has been signed. I have no retirement anymore. I have no savings. I’ll never own property. For a lifetime to be wiped away over a name change is ridiculous," Najberg said.

A name change isn't uncommon. People change their names for multiple reasons, the main one being marriage, so it would stand to reason that insurance companies know how to navigate name changes within their system. What makes this name change so different if other companies had no issue?

It took Najberg months of phone calls to find out the reason for her denials was due to her name change and she was advised to submit under her dead name. But submitting an insurance claim under a different name than your own is insurance fraud and kind of illegal, she protested.

For Najberg, who's had a lifelong passion for helping people, the fight isn't just for herself.

"If they’re doing this to me, they have to be doing this to other people. If they get away with this, they’ll do it to other trans providers," Najberg told Upworthy.

If you'd like to support Dr. Tiffany in her fight against the insurance companies, you can sign her petition here, and if you'd like to donate to help her pay rent and get needed medical supplies, you can do that here.

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Three women, three MS journeys: How multiple sclerosis looks different for everyone

Gina, Nathalie and Helga share their reactions to being diagnosed with MS and how they stay informed and positive in the face of ever-changing symptoms.

Courtesy of Sanofi

Helga, Nathalie and Gina all have MS, and their experiences show how differently the disease can manifest.

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It’s been 155 years since neurologist Jean-Martin Charcot gave the first lecture on a mysterious progressive illness he called “multiple sclerosis.” Since then, we’ve learned a lot. We know MS causes the immune system to attack healthy tissue, including damaging the brain and spinal cord. Resulting symptoms can be debilitating and include fatigue, blurred vision, memory problems and weakness. Huge advancements in our understanding of MS and its underlying causes, as well as treatment advances, have been made in the past few decades, but MS remains a complex and unpredictable reality for the 2.8 million+ people diagnosed around the world.

Ironically, the only real constant for people living with MS is change. There’s no set pattern or standard progression of the disease, so each person’s experience is unique. Some people with MS have mild symptoms that worsen slowly but sometimes improve, while others can have severe symptoms that drastically alter their daily lives.

All people with MS share some things in common, however, such as the need to stay informed on the ever-evolving research, find various lines of support and try to remain hopeful as they continue living with the disease.

To better understand what navigating life with MS really looks like, three women shared their MS stories with us. Their journeys demonstrate how MS can look different for different people and interestingly, how the language used to talk about the disease can greatly impact how people understand their realities.

woman with horse, woman riding horseGina loves riding her horse, Benita.Courtesy of Sanofi

Gina—Hamburg, Germany (diagnosed with relapsing multiple sclerosis in 2017)

When her youngest son was 4 months old, Gina started having problems with her eye. She’d soon learn she was experiencing optic neuritis—her first symptom of MS.

“Immediately after the diagnosis, I looked up facts on MS because I didn’t know anything about it,” Gina says. “And as soon as I knew what could really happen with this disease, I actually got scared.”

As her family’s primary income provider, she worried about how MS would impact her ability to work as a writer and editor. Her family was afraid she was going to end up in a wheelchair. However, for now, Gina’s MS is managed well enough that she still works full-time and is able to be active.

“When I tell somebody that I have MS, they often don't believe me the first time because I don't fulfill any stereotypes,” she says.

Overwhelmed by negative perspectives on living with MS, Gina sought support in the online MS community, which she found to be much more positive.

“I think it’s important to use as many positive words as you can when talking about MS.” It’s important to be realistic while also conveying hope, she says. “MS is an insidious disease that can cause many bad symptoms…that can be frightening, and you can't gloss over it, either.”

To give back to the online community that helped her so much, Gina started a blog to share her story and help others trying to learn about their diagnosis.

Though she deals with fatigue and cognitive dysfunction sometimes, Gina stays active swimming, biking, riding horses and playing with her sons, who are now 11 and 6.

Cognitive dysfunction is common in MS, with over half of people affected. It can impact memory, attention, planning, and word-finding. As with many aspects of MS, some people experience mild changes, while others face more challenges.

Gina says that while there’s still a lot of education about MS needed, she feels positive about the future of MS because there’s so much research being done.

woman in wheelchair holding medal, woman rowingNathalie is an award-winning rower with multiple international titles.Courtesy of Sanofi

Nathalie — Pennes Mirabeau, France (diagnosed with relapsing-remitting multiple sclerosis in 2002)

Nathalie was a teenager and a competitive athlete when she noticed her first symptoms of MS, but it would take four years of “limbo” before she was diagnosed.

“Ultimately, the diagnosis was more of a relief, than a shock,” she says. “Because when you have signs and you don’t know why, it’s worse than knowing, in the end, what you have.”

However, learning more about the disease—and the realities of disease progression—scared her.

“That glimpse of the future was direct and traumatic,” she says. Her neurologist explained that the disease evolves differently for everyone, and her situation might end up being serious or very mild. So, she decided to stop comparing herself to others with MS.

She said to herself, “We’ll see what happens, and you’ll manage it bit by bit.”

By 2005, Nathalie’s MS had progressed to the point of needing a wheelchair. However, that has not dampened her competitive spirit.

Nathalie began her international rowing career in 2009 and has won multiple world titles, including two Paralympic medals—silver in London and bronze in Tokyo. Now, at 42, she still trains 11 times a week. Fatigue can be a problem, and sometimes hard workouts leave her with muscle stiffness and shaking, but she credits her ongoing sports career for helping her feel in tune with her body’s signals.

“Over the years, I’ve learned to listen to my body, letting my body guide when I need to stop and take breaks,” she says.

Nathalie explains that she used to only look backwards because of the initial shock of her diagnosis. In time, she stopped thinking about what she couldn’t do anymore and focused on her future. She now lives in the following mindset: “Even when doors close, don’t miss out on those that open.” Instead of focusing on what she can’t do, she focuses on the opportunities she still has. Right now, this includes her training for the 2024 Paralympic Games in Paris, where she will compete for another rowing medal.

“I only go forward,” she says. “Well, I try, anyway…It’s easy to say, it’s not always easy to do. But that’s what I try to do.”

woman exiting water after swimming, woman with great daneHelga's Great Dane has become a helpful and beloved companion.Courtesy of Sanofi

Helga—Johannesburg, South Africa (diagnosed with relapsing multiple sclerosis in 2010)

When Helga first started having balance issues and numbness in her feet, she chalked it up to her training as a runner. But when the numbness moved to her face, she knew something was wrong. She never guessed it was MS.

“When I was diagnosed, I felt completely overwhelmed and clueless,” Helga says. “I felt that I had nowhere near enough information. I did not know anything about the disease…I had no idea that it was going to be a process of continually monitoring and adjusting your lifestyle.”

In the beginning, Helga’s symptoms developed slowly, and she didn’t appear ill to others. She was even able to run for a few years after her diagnosis, but she couldn’t do marathons anymore, and she began to fall frequently due to balance issues and right-foot dragging. Then her cognition issues became more problematic, especially in her job as a trainer in a printing company.

“My executive function, decision-making and short-term memory were affected to the point that I was eventually medically unfit for work,” she says. She stopped working in 2017.

However, she didn’t stop living life. Even though she could no longer run, she continued to swim competitively. She got a Great Dane puppy and trained him as a service dog to help her walk. She also serves as vice chair of the patient support organization Multiple Sclerosis South Africa, and she advises others who have been diagnosed to join a patient advocacy group as soon as possible to get reliable information and meet others with MS.

Helga says she is “hopeful” about the future of MS. “I must say that I am so grateful that we have all the new medications available, because my life would not be the same if it wasn't for that,” she adds.

Part of how she manages her MS is by looking at the positives.

“If I could tell the world one thing about MS, it would be that MS is an incurable disease of the nervous system, but it's also the greatest teacher of valuing your health, family, friends, and managing change in your life,” she says. “My life is diversified in a way that I never, ever thought it would, and MS has been honestly the greatest teacher.”

Each MS journey is unique – with each person impacted experiencing different struggles, successes, and feelings as they manage this unpredictable disease. But the common thread is clear – there is a critical need for information, support, and hope. We are proud to participate in World MS Day and share these incredible stories of living life while living with MS. To learn more about MS, go to https://www.sanofi.com/why-words-really-matter-when-it-comes-to-multiple-sclerosis.

MAT-GLB-2301642-v1.0-05/2023

This article was sponsored by Sanofi. Participants were compensated when applicable.

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