Considering Your Next Move After A Denied Insurance Claim

If no one ever got sick and never needed to file a claim, they would have a much more friendly health insurance company. In reality however, they spend an excessive amount of time and resources discounting or flat out denying claims. No one expects every claim to be paid without question, that may or may not result in the company going out of business.

Many health insurance companies try many tactics to deny claims and therefore save money, when in fact they could be spending more money trying to not pay the claim than the actual claim payout and sometimes end up paying for some of the treatment anyway. Fair treatment plans should be developed and proper treatment should be prescribed by a medically trained physician and the patient required to follow the doctors orders and the health insurance company have only limited say so concerning any specifically prescribed treatment.

This is becoming a huge battle for many doctors who admit it is much easier to stay away from some types of treatments and pick a treatment they know will not cause any major conflicts with the insurance company, regardless of the terms of the policy. Many ill patients are quickly learning the whole process can cause them to submit to the decision of the insurance company without much of a fight.

In the usual course of things, the doctor will prescribe what they believe will be the best treatment, only to have their recommendations denied by the insurance company, however you do have some options to choose from at this point. Filing a complaint and have it reviewed is one. You can also, according to the new health care laws have the denial reviewed by an independent evaluator. You do have a right to defend the doctors decision over the insurance company decision and request the claim denial reviewed.

You always have the option to continue to fight the claim denial and in the mean time you might have to decide if you can afford the treatment and pay for it yourself or rethink the choices and treatments that will be approved by the insurance company. This might not be what you expected to happen, but it is and you will find that this could take up a lot of time wrestling with the health insurance company about this issue. You must always remember that your health is very important and is very important that you receive the treatment you need in a timely manner.

By: Ethan C Kalvin

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