America's Health Insurance Plans (AHIP) is a national trade association representing nearly 1,300 companies that provide health insurance coverage to more than 200 million Americans.
The companies we represent provide health insurance to employers, individuals and people in public programs such as Medicare and Medicaid. All together, these companies provide coverage to more than 200 million people – 170 million of whom are covered through their job or their family member’s job.
Each plan is different. Different employers and individuals choose different plans. The plan is then administered to ensure that hospitals, doctors and other health care providers are appropriately paid for their services and pursuant to the terms of the particular plan.
Health insurance plans pay approximately 5 billion claims annually. We work very hard to ensure that those claims are paid promptly and accurately and in the overwhelming majority of instances they are. In fact, 70 percent of all medical claims are now being processed within 2 weeks or less.
We want to ensure that every American is getting the full benefits of the coverage that they or their employer has purchased. That’s why America’s Health Insurance Plans has created this website to educate consumers about the appeals process.
Every health insurance plan as well as public programs like Medicare and Medicaid, has an appeals process. The appeals process is an opportunity for people to ask their health plan to take a second – or sometimes even a third or fourth – look at their claim to ensure that the action taken was appropriate.
We believe that every American should have access to high-quality, affordable health care coverage.
In order to meet that goal we are doing the following: