Your insurance company just denied your claim for that procedure, treatment, or doctor’s office visit that you were sure was something they were supposed to cover. You may be considering fighting that disputed claim, but have no idea how to go about doing that. Here are some helpful hints that can get you started.
It can be frustrating to discover that your health insurance company, that you have been faithfully paying premiums to, has refused to cover some of your medical bills. Those bills are probably going to be higher than your budget can comfortably handle. This could leave you feeling some anxiety about how on earth you are going to be able to pay that bill out of pocket.
You could try and dispute the claim. A study done by the Government Accountability Office shows that around half of all appeals that were made regarding health insurance claims caused the insurer to reconsider, and actually pay the bill. It can be worth it to fight that denied claim.
You can increase your success with your claim, and save yourself a certain amount of stress, if you use your resources wisely. One of the first things you should do is get organized. Take the time to “do your homework”, and go over your health insurance plan. Find out exactly where your health insurance plan says it covers the health care that your insurer has refused to cover.
Now is the time to start a paper trail that reinforces that your insurance company truly is supposed to cover that claim. Hang on to any receipts or records that show the date that the health care was given. Locate your doctor’s name on the list given to you by your insurer that identifies all the physicians that are a part of its network. If your doctor gave you a referral, see if you can get a copy of it.
Your doctor might be able to help you out with other important pieces of evidence. Perhaps your insurer denied the claim because of a clerical error. You had procedure A done, which your health insurance covers. But, the office worker accidentally indicated that you had treatment B done, instead, and treatment B is something that your insurer clearly doesn’t cover.
Your doctor’s office can connect with the insurer, clear things up, and get your denied claim covered. Sometimes, a doctor can write a letter to your health insurance company that clarifies that the health care that your insurer refused to cover truly was something necessary for you to have. There is a good possibility that your doctor may have some experience working with patients who have had their claims denied. Take advantage of his or her experience with these types of situations.
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