Denials of health claims

[moneysense]

With the new health care laws it it easier to fight your insurance company if you are denied on your claims.

You now have the right to an external review board when it comes to fighting a claim denial.

It used to be that it was according to state and and insurer whether you could fight a claim denial but now it is evened out over all the states and insurers. And every state has to have a process for external appeals in place.

These regulations will apply to new health insurance plans on September 23rd of this year.

[dimetime]

It is about time something like this was put into effect. I have heard of a whole lot of people who were denied something by their insurance companies.

I know of one girl who was denied surgery that she needed because it was not covered by her insurance. She really went into the hole getting up the money she needed for this surgery.

They claimed that it was cosmetic surgery and was not life threatening. Her nasel passages were extremely small and she had a lot of trouble breathing especially at night when she tried to sleep.

She had the surgery and now breathes just fine, however her insurance company claimed that this was a cosmetic surgery when in fact it wasn't.

She has of course changed her insurance company now, but if they had this external review thing going back then, well she may have had an easier time getting the surgery that she needed.