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Is there anything you are able to do to give the system a boot and get it to cough up a decision in your favor? Yes, there are several things you are able to do for yourself, however to cut to the chase and get fast results, hire an experienced insurance attorney. Attorneys who have a track record in dealing with health insurance claims are worth their weight in gold in getting you a satisfactory resolution to your claim dispute.
In the meantime, here are some of the things you may do to get things moving. The first thing on your list should be talk to your health insurance provider and get them to review the denial. It may be just a simple error that can be chalked up to the use of the wrong diagnostic code.
If you are making these kinds of phone calls, make a record of them, including to what you spoke and what they said, etc. In any event, if the claims review is a bust, you may opt to start the formal claims review process. To do this, if you happen to get health insurance through your workplace, get some advice from them. Also, check back with your doctor and get a letter outlining why you needed a specific treatment.
If none of these works, you do have the option of going higher up the chain of command in the health insurance company and speak to a Claims Manager; however, this might be the point to cut your losses and call an experienced attorney. An insurance attorney will be able to cut through a lot more red tape than you are able to do on your own, and in a lot less time.
If there is one thing that health insurance companies do not like, it's pressure to set up and do right by their customers. If you have a skilled health insurance lawyer on your side, the pressure to settle or be sued is often a deciding factor in your favor.
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Source by Lance Sharp
