Problems within the health insurance industry are a hot topic. Even if you are covered through an employer-sponsored policy, health insurance claims denials are commonplace. Rather than accepting defeat and paying these costs out of pocket, find out the process for appealing denied health insurance claims.
You rely on employer-provided health insurance to protect you in the event of illnesses or injuries. Depending on the type of coverage you have, you may be contributing significant amounts of your own money for this coverage. Having your claim denied can come as a shock, but it is actually quite commonplace. According to studies conducted by the American Association of Retired People (AARP), more than 200 million claims are denied or disputed each year. Common reasons for this include:
The first step in dealing with a denied claim is to dispute it with the insurance company. If it is a problem with coding or other administrative errors, this may easily resolve the situation. In more complicated cases, you have the right to appeal the insurer’s decision. If it involves employer-provided health insurance, the Employee Retirement Income Security Act of 1974 (ERISA) governs the appeals process. Steps involved include:
If you are facing a denied health insurance claim, reach out to Bartolic Law. We guide you through the appeals process, providing the aggressive legal representation needed to protect your rights. Call or contact our Chicago ERISA attorney online and request a consultation today.