An appealing solution to health insurance denialsMichelle Singletary
Understand the reason for the denial.Ask that it be clearly stated, in writing, and that the appeal process for this particular kind of denial be made clear to you. Quite often the insurance company appears to hope that by saying “no” and offering no further information, it can st...
If you're not happy with the outcome, you can take it to the next level.Ask for an external appeal. People who don't work for your insurance company -- called an independent third party -- will do their own review. Usually, you will have four months from the denial of your internal...
Here’sa series written by my friend Mandi Bishopabout how a hip injury was put into a doctor’s record as a shoulder injury, and the treatments were denied. This is a model of how to make an appeal of an insurance denial; most of us do not have the resources or the knowledge to d...
after waiting patiently for a couple of months, you receive a denial letter in the mail. Naturally, you are shocked and dismayed. Your initial reaction is to call the insurance company to complain and to demand an explanation for the adverse decision. But you should avoid acting impulsively. ...
It is inferred that the claims of patients insurance coverage may be delayed due to the said regulation. It has been exercised to avoid inconsistency among plans that would lead to unnecessary claim payment delays. Moreover, COB-related denials and post-payment refund requests must be inspected ...
Suggests a strategy to be adopted by health care facilities when there is a denial of claims by insurance providers. Significance of documentation for all written and oral communications with the payers; Recommendations of Jeffrey W. Shutak on components of an effective appeal letter; Importance of...