24. The Ultimate Guide to Appealing Health Insurance Denials

Welcome to the Balanced FI Podcast, episode 24! Thank you so much for listening in! 

Appealing health insurance denials is the best (maybe only?) way to increase the chances your health insurance provider will cover the requested medical treatment. So many times a claim is denied automatically, or without sufficient investigation, so it falls to the patient (or patient’s representative) to appeal the denial and seek coverage. 

To appeal a health insurance denial, you need to:

• Request coverage
• Receive the denial
• Call insurance
• Get more information
• Contact your provider
• Follow the appeal process
• Ask what the next step is

RESOURCES:

Read: The Ultimate Guide to Appealing Health Insurance Denials

Read: Meet RaLea

Fax Zero

Patient Advocate Foundation

 

SOURCES:

HeathCare.gov: Appealing a health plan decision - External Review

Center for Medicare Advocacy: Frequently Asked Questions (FAQs) Regarding the Jimmo v. Sebelius “Improvement Standard” Settlement