{"id":18014,"date":"2019-01-20T13:15:13","date_gmt":"2019-01-20T18:15:13","guid":{"rendered":"http:\/\/thepapergown.zocdoc.com\/?p=18014"},"modified":"2023-03-03T15:48:51","modified_gmt":"2023-03-03T20:48:51","slug":"how-to-appeal-a-health-insurance-claim-denial","status":"publish","type":"post","link":"https:\/\/www.zocdoc.com\/blog\/guides\/how-to-appeal-a-health-insurance-claim-denial\/","title":{"rendered":"How to Appeal a Health Insurance Claim Denial"},"content":{"rendered":"

After trying to conceive on their own without success, a couple from outside Chicago wanted to use vitro fertilization, or IVF. Their insurance company refused to pay for the procedure, saying that IVF wasn\u2019t medically necessary. The couple appealed the denial, only for the insurer to deny the claim again, this time arguing that<\/span> the company had already paid for one round of IVF treatment, even though it hadn\u2019t. <\/span>Unsure of what to do next,\u00a0the couple hired Gayle Byck to unravel the reasoning behind \u2014 and hopefully fight \u2014 their denied claim. <\/span><\/p>\n

\u201cI called and asked the insurer, \u2018Could you tell me the date for the treatment?\u2019\u201d says Byck, who founded <\/span>InTune Health Advocates<\/span><\/a>, a private patient advocacy practice based in Deerfield, Illinois. \u201cThey kept me on hold for over an hour. They called me back the next day and agreed that my client had never had the procedure.\u201d <\/span><\/p>\n

With that, the couple\u2019s insurer agreed to pay their IVF bill.<\/span><\/p>\n

Appealing a denied insurance claim can be an aggravating, time-consuming process. To give yourself the best chance of winning an appeal, you\u2019ll need to be persistent, know how your insurance plan works and be vigilant about noticing and correcting billing mistakes. With help from experts, we put together a primer on the appeals process.<\/span><\/p>\n

Know your policy<\/h3>\n

Before you seek any kind of medical treatment, make an effort to understand what your insurance plan covers and what it doesn\u2019t. It\u2019s important to know if a provider is in-network, whether your plan requires you to meet a yearly deductible and what that amount is before your insurer will cover your care. Call the customer service number on your health insurance card and ask.\u00a0<\/span><\/p>\n

Once you know the ins and outs of your coverage, it will be easier to flag an unwarranted denial. \u201cRemember, your insurance plan is a contract with your insurance company,\u201d says Byck. \u201cReally understand why they are denying it. Refer back to your policy so you can understand what your rights are.\u201d<\/span><\/p>\n

Craft your appeal<\/h3>\n

While patients often learn about claim denials after the fact, insurance companies may also deny coverage for a treatment beforehand, as with the Chicago couple\u2019s IVF <\/span>claim denial.<\/p>\n

A claim might be denied for several reasons, says Caitlin Donovan, director of outreach and patient affairs for the <\/span>National Patient Advocate Foundation<\/span><\/a>, a group that helps people with chronic illness decipher denied health claims. Here are the most common scenarios: <\/span><\/p>\n

1) A patient receives care in an inappropriate setting, such as by going to the ER for a sore throat. <\/span><\/p>\n

2) A patient isn\u2019t eligible for a medical benefit, i.e., their treatment isn\u2019t deemed medically necessary. <\/span>This tends to happen when a patient receives services for a diagnosis the physician failed to document.<\/span>\u00a0<\/span>Say someone gets a headache, blacks out, hits their head and twists an ankle. A doctor orders CT scans and documents the reason, such as headache and head trauma. The physician also orders an X-ray for the twisted ankle but doesn’t document the reason. The insurer may approve the CT scan but deny the ankle X-ray as not medically necessary, since the supporting medical diagnoses didn\u2019t mention or diagnose an ankle injury.<\/p>\n

3) A patient doesn\u2019t resolve a claim in time. <\/span>Watch for deadlines: You have 180 days from the date of service to appeal a denial.<\/span> The 180-day appeal window will be specified in an explanation of benefits form. Following any appointment or insured healthcare service (i.e., unless a patient self-pays for care), a patient will receive an EOB stating how much their insurance company paid for the treatment and how much they still owe. The deadline for an appeal is always based on the date of a treatment or medical visit \u2014 even when the EOB letter isn\u2019t sent until weeks or months afterwards. When an insurance company denies a claim, the EOB will explain why and tell you how to file an appeal to counter the denial. \u201cThe EOB will tell you where to send any additional information, and it\u2019s important to follow all the directions,\u201d says Byck, adding that the insurance company will look for any reason to turn down an appeal.<\/span><\/p>\n

Get your doctor on your side<\/h3>\n

\u201cOnce you have the exact reason the claim was denied, use that language to shape your own appeal,\u201d Donovan says. \u201cThink of it like a contract dispute and use facts, not emotions.\u201d <\/span><\/p>\n

If your insurer says that your treatment was not medically necessary, or that it’s considered experimental, go to your provider and ask them to help you prove its necessity, with documentation. <\/span><\/p>\n

Always ask your provider to confirm the diagnostic code(s) they used for your diagnosis and treatment. On the off-chance they coded <\/span>something\u00a0incorrectly, they\u2019ll need to resubmit the claim using the right code(s). <\/span>If there were no coding mistakes, ask your<\/span> provider to write a letter to your insurance company in support of your appeal. It\u2019s helpful to have a physician endorse your appeal because it will be evaluated by the insurance company\u2019s own healthcare providers, <\/span>who are hired to review claims. \u201cSometimes a company\u2019s provider is not a specialist in the area,\u201d says Donovan. \u201cI\u2019ve heard patients say they need a certain neurological treatment, and the insurance provider reviewing it is an oncologist. It\u2019s one more layer in why dealing with the healthcare system can be so frustrating.\u201d<\/span><\/p>\n

Do your own research<\/h3>\n

If you\u2019re dealing with a denial from a private insurer, figure out if Medicare covers the treatment. (Donovan says a Google search should do the trick.) If the treatment is covered by Medicare, that means it\u2019s considered the clinical \u201c<\/span>standard of care<\/span><\/a>\u201d and should be covered by most private insurers. <\/span><\/p>\n

Another way to show that a treatment is considered medically necessary for a given diagnosis is to find medical journal articles that say the treatment is an accepted method of care. You can always ask your doctor\u2019s office for help with this research. But if you want to do it on your own, stick to reputable, peer-reviewed journals (meaning those whose articles are evaluated by independent medical experts before publication). Two of the best known medical journals are <\/span>The New England Journal of Medicine <\/span><\/i>and JAMA<\/em> (<\/span>Journal of the American Medical Association)<\/span><\/i>. A comprehensive collection of peer-reviewed articles can be found on <\/span>Pubmed<\/span><\/a>, the National Institutes of Health\u2019s database. You can also search for studies on <\/span>Google Scholar<\/span><\/a>. <\/span><\/p>\n

\u201cOne way to determine the legitimacy of any journal, and thus the research inside, is to find the publication’s <\/span>influence score<\/span><\/a>,\u201d Donovan says. (Influence score basically measures how often an article is cited in other reputable research.) \u201cIf an article is frequently cited, it should be considered a good source.\u201d<\/span><\/p>\n

Try again<\/h3>\n

If your appeal is denied, read your insurer\u2019s explanation and try again. Then again, if necessary. \u201cOur case managers are the best, and it still takes, on average, 22 calls for [an appeal to succeed],\u201d Donovan says. \u201cAnd we know it\u2019s really frustrating for the patient to work through even one call.\u201d<\/span><\/p>\n

To appeal one of her own denials, Donovan talked to her physician\u2019s office and learned that one of her claims had been coded incorrectly. She then spent time on the phone with her insurance company to make sure the code was fixed in its computer system. Then she waited: \u201cI had the answer on the first day, and the claim took a year to resolve. It\u2019s important to dot your I\u2019s and cross your T\u2019s.\u201d<\/span><\/p>\n

If a claim dispute drags on, you will likely start to receive bills from your provider requesting payment. In this situation, Donovan says, contact whoever is billing you and let them know you\u2019re disputing the claim. If you do this, the billing company \u2014 which could be for a doctor\u2019s office, a hospital or wherever you received treatment \u2014 should be willing to hold off looping in a collections agency, since they know you\u2019re actively working with the insurance company to resolve payment.<\/span> The last thing you want to deal with is the trouble of fighting an insurance claim while also battling a collection agency.<\/span><\/p>\n

Don\u2019t hesitate to push back<\/h3>\n

How often do medical bills <\/span>contain errors, such as incorrect or incomplete codes, or wrong information about the patient or provider?\u00a0Estimates vary widely; one 2017 <\/span>report<\/span><\/a> put the error rate between 30 percent and 90 percent. \u201cPeople tend to be shy about pushing back on denials or challenging bills with errors, and they shouldn\u2019t be,\u201d says Donovan. “It’s important to get things right when medical <\/span>issues and financial security overlap, especially if you are putting off an appointment or procedure over concern about how much it costs.\u201d<\/span><\/p>\n

Donovan recommends advocating for yourself as you would for a child: \u201cIt\u2019s not unlikely that an insurance company is wrong. Obstacles will be thrown in your path. You have to have conviction.\u201d<\/span><\/p>\n

To beat an insurer at its own game, keep fighting. \u201cInsurance companies are counting on attrition,\u201d says Byck. \u201cIf you stick with it, your chance of success goes up.\u201d<\/span><\/p>\n

\n

Ready to book a doctor’s appointment? Visit Zocdoc.<\/span><\/a><\/span><\/h1>\n","protected":false},"excerpt":{"rendered":"

Your insurance company refuses to pay for your treatment. 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