27
June
2019
|
06:42 PM
America/New_York

Your Appeals Checklist

Summary

Follow these steps to navigate the appeals process.

By Thomas Vincz, Public Relations Manager


When facing a serious challenge to the health of someone you love, your focus should be on getting them healthy again – not on your insurance coverage. But sometimes, the health care system doesn’t work as it should and you might find yourself disagreeing with the way your health insurer handled your claim. If that happens, you have options to request a change or reversal of the insurance company decision. Appeal rights were expanded under the Affordable Care Act, requiring insurance companies to tell you why they did not agree with your claim as submitted. Now, you have six months to appeal. You can follow these tips as you move through the appeals process.

For more information on the appeals process, refer to this article which provides additional details on the different types of appeals. 

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Appeal rights, levels, and filing deadlines, may vary by health plan. For specific information on your right to appeal a claim denial, please review your official plan documents.