My Insurance benefits claim has been denied. What can I do?

If you believe your claim was inappropriately denied there are several things that you can do. Every health insurer has an internal review process. You can find out about that process by calling the number on the explanation of benefits (EOB) document that you received and asking for information on the appeals process for your health plan. Read More »

Preparing for an Appeal

The appeals system has been put in place for people to ensure that if there has been error that it can be corrected. However, being prepared for an appeal will make it go much more smoothly. A few tips you should consider. If you don’t understand the reason for your claim being denied, start by calling or writing your health plan to ask for a full explanation. Read More »

Before you appeal, here are some suggestions:

  • Review the benefits of your health insurance plan
  • Request a full explanation of the reason for the denial
  • Engage your doctor - ask for a letter explaining why you need the treatment or service
  • Include as much supporting documentation as possible
  • Ask for assistance from your doctor, health plan or state department of insurance