With increasing frequency, people are facing a denied insurance claim. It is sad that individuals, when they need it most, are denied essential treatments and procedures.
In fact, according to a study, nearly 200 million claims are denied each year in America due to a variety of reasons.
Based on research, it has been found that claimants can do certain things even with a denied insurance claim.
Here are a few useful tips:
1. Identify why your claim has been denied
Read the letter of denial, immediately get in touch with your doctor, insurer, and the clinic or hospital, and learn why your claim was denied. The most common reasons for refusal include the following:
• Absence of prior authorization
• Erroneous insurance information
• Inadequate medical necessity
• Claim done beyond filing limits
2. Apply once again and repeat, if necessary
It is not unusual for insurance companies to refuse altogether or hold payment for as long as possible. In fact, they use software called claim review programs to sort through millions of applications.
These programs operate by finding technical faults in billing codes submitted by health care providers, hospitals, and clinics. Needless to say, the program’s algorithms are not consumer friendly.
3. Keep records electronically
Safeguard all your records in digital mode as reference when you are dealing with your insurance company. Communicate everything with your doctor, insurer, and other agencies via e-mail. See to it that your questions are explicit so that they do not confuse even a third party reader.
4. Find the cost of your treatment
You will be amazed to find that most denied claims are for those where treatments are expensive. This can provide insight into how you can deal with your medical provider.
A denied insurance claim is not the end of the world. With knowledge and tenacity, you can fight the insurer and get what is due to you.
Share Lawyers, established in 1987, is a well-known lawyer firm specializing in long term disability insurance claims.
In fact, according to a study, nearly 200 million claims are denied each year in America due to a variety of reasons.
Based on research, it has been found that claimants can do certain things even with a denied insurance claim.
Here are a few useful tips:
1. Identify why your claim has been denied
Read the letter of denial, immediately get in touch with your doctor, insurer, and the clinic or hospital, and learn why your claim was denied. The most common reasons for refusal include the following:
• Absence of prior authorization
• Erroneous insurance information
• Inadequate medical necessity
• Claim done beyond filing limits
2. Apply once again and repeat, if necessary
It is not unusual for insurance companies to refuse altogether or hold payment for as long as possible. In fact, they use software called claim review programs to sort through millions of applications.
These programs operate by finding technical faults in billing codes submitted by health care providers, hospitals, and clinics. Needless to say, the program’s algorithms are not consumer friendly.
3. Keep records electronically
Safeguard all your records in digital mode as reference when you are dealing with your insurance company. Communicate everything with your doctor, insurer, and other agencies via e-mail. See to it that your questions are explicit so that they do not confuse even a third party reader.
4. Find the cost of your treatment
You will be amazed to find that most denied claims are for those where treatments are expensive. This can provide insight into how you can deal with your medical provider.
A denied insurance claim is not the end of the world. With knowledge and tenacity, you can fight the insurer and get what is due to you.
Share Lawyers, established in 1987, is a well-known lawyer firm specializing in long term disability insurance claims.