Posted on Feb 5, 2023
Fighting back against health insurance denials
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Navigating the American healthcare system can be a challenge.
Every year, insurance companies reject millions of claims by patients seeking many types of treatment — everything from MRIs and surgeries to medications. And appealing those denials can be challenging.
A study by the Kaiser Family Foundation found that patients under the Affordable Care Act only appeal about 0.1 percent of claims that are rejected.
A new investigation by ProPublica and Capitol Forum looks into the world of health insurance denials, and what that appeal process looks like.
Every year, insurance companies reject millions of claims by patients seeking many types of treatment — everything from MRIs and surgeries to medications. And appealing those denials can be challenging.
A study by the Kaiser Family Foundation found that patients under the Affordable Care Act only appeal about 0.1 percent of claims that are rejected.
A new investigation by ProPublica and Capitol Forum looks into the world of health insurance denials, and what that appeal process looks like.
Fighting back against health insurance denials
Posted from the1a.org
Health
Medical
Insurance
Posted 1 y ago
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PO1 William "Chip" Nagel good day Brother William, always informational and of the most interesting. Thanks for sharing, have a blessed day!
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PO1 William "Chip" Nagel
..."There are two ways to appeal a health plan decision:
Internal appeal: If your claim is denied or your health insurance coverage canceled, you have the right to an internal appeal. You may ask your insurance company to conduct a full and fair review of its decision. If the case is urgent, your insurance company must speed up this process.
External review: You have the right to take your appeal to an independent third party for review. This is called external review. External review means that the insurance company no longer gets the final say over whether to pay a claim."...
..."There are two ways to appeal a health plan decision:
Internal appeal: If your claim is denied or your health insurance coverage canceled, you have the right to an internal appeal. You may ask your insurance company to conduct a full and fair review of its decision. If the case is urgent, your insurance company must speed up this process.
External review: You have the right to take your appeal to an independent third party for review. This is called external review. External review means that the insurance company no longer gets the final say over whether to pay a claim."...
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It definitely is a challenge. No doubt regardless of what insurer you have. BTW, socialized medicine in Canada or the UK is NO BETTER. They have years long wait lists for procedures we get scheduled and done within a week.
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PO1 William "Chip" Nagel
I had No Problem with the "Socialized" Medicine in the UK, Worked Out very well for Me and My Family.
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