What Can You Do If You Are Denied an Insurance Claim?

Ok, so you have been denied and already stated your appeals process. What happens next? Do you need to stand around and wait for them to get back to you? You might need to try another approach on top of your appeal. But you need to know what your options are. Here is the second batch of tips to help you if you have suffered through the trouble of having a claim denied.

An Appeal…But Now What

It is not unreasonable to think that it may take 2 or 3 months for them to figure out your appeal and come to some conclusion. Well, in some cases that may not be an option, you might not be able to wait that long. So then what can you do?

You need to look for third party help. Many times you can look to have your process expedited and reviewed. This means that you will need to enlist the help of the people who have treated you. Follow the steps you went through. If you started with your normal doctor, then begin there. Find someone in that office to end you, and get them to note each visit you made and for its original purpose. If they cannot help, then move on.

If you went to the hospital next, then go there. Follow the same steps there as you did at the doctor’s office. Get all the work together, and talk over your process with someone. The more familiar you get with all parties involved and aware of the claim the better. That way when the insurance company comes calling everyone will know their role.

There is also the option of a health care attorney. But this option does come with an expense, and it might not be something that a lot of people want to undertake. These appeals are so important, but it is understandable that people do not have money to spend on extras.

When it actually comes to the appeal you need to know how it works. Your case will be heard by a panel of three different doctors. They will then come to the conclusion on what needs to be done. It is so important that you make sure the panel is three doctors who specialize in the area of your problem. That way you know you will be getting a fair shake, by people who actually know what is going on.

Take Action!

You really need to take action and be on the offense in claim situations. Do not sit there and let them take control of your claim and your appeal. Remember, you are looking for money out of them. So why would they want to give you money and be quick about it? Take control and go get the money you deserve. This means that you should not wait for them to do anything. Take action and be in control.

Additional Resources:

• One-Fourth of Americans Say Insurance Fraud is Acceptable
• Fighting Insurance Fraud