If your claim is denied, your doctor can resubmit the claim, or you can file an appeal to try to get the insurance company to change its decision. Hea

Insurance Claim Denials: Worst Companies and How to Appeal

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2024-12-04 18:00:02

If your claim is denied, your doctor can resubmit the claim, or you can file an appeal to try to get the insurance company to change its decision.

Health insurance claims can be denied because of a simple coding error or because of a more complex problem. The health insurance company you have can affect how likely it is your medical claim will be denied. For example, UnitedHealthcare denies about a third of in-network claims.

Based on available in-network claim data for plans sold on the marketplace. Anthem is not included in the average for Blue Cross Blue Shield.

The insurance company may say there is a problem with the paperwork or the procedure wasn't a necessary treatment. The reason they denied your claim will be important when deciding what to do next and how you can appeal their decision.

A coding issue could cause insurance to deny all or part of your claim. Depending on which company you have, the claim denial letter may be very clear about what was coded wrong. Or you may have to call them to find out specifically which code is the problem.

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