Health insurance claim denied? What to do…
Did you know that 94 percent of health insurance denials are never appealed even though 70 percent of those that are appealed are granted? So what makes us so reluctant to appeal?
If you ever had your health insurance claim denied you know how frustrating that can be. It feels like insult added to injury. So we convince ourselves that there is nothing we can do and don't appeal. Experts convince us otherwise… making the effort to appeal can pay off!
First of all, find out why your claim has been denied. Insurance companies MUST provide the reason for the denial and explain your appeal options. It may be as simple as a missing form, an error in the calculations or perhaps you forgot to sign the claim. These are easy to fix. If, on the other hand, the denial is based on policy interpretation, you may have to do a bit of homework. According to experts at the Oley Foundation, you may have to prove medical necessity and safety and efficacy of experimental/investigational treatments. They also remind us that appeal filing deadlines are very important and to pay attention to the format of the appeal letter.
For more informaion and sample appeal letters, check out the following links:
- How to Write a Winning Insurance Appeal
- Writing Winning Insurance Appeal Letters
- How to Win Health Insurance Appeals
- How to Appeal a Health Insurance Denial
- Travel Insurance Claim Denied? Here is What to Do
- How to Write a Letter of Appeal to Your Insurance Company
- Why your Health Insurance Medical Appeal was Rejected
- Your Guide to the Appeals Process
- Jennifer Jaff Center website
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