Reader question:

My health insurance claim was denied. What do I do?

Mary

Great question.

Not being in control of your health care is a very scary thing to think about, and when you get a health insurance claim denied, it leaves you feeling as though you don’t have any options left. This is a most stressful situation, because if you want to get out if it you have to take charge and change things, and provide your health insurance company with incentive to do that, but since the consequences of having a health insurance claim denied are so overwhelming, it’s hard to get up the strength to do all that once you’re put in that situation.

The best thing to do if you get your health insurance claim denied is to ask for a face to face appeal hearing. Almost all of the health insurance plans out there will let you come to one, maybe more, of the appeal hearings over your case. If you request one of these, then your case will be looked at all over again and you’ll be able to present new evidence, and maybe get a chance of getting your health insurance claim approved this time around.

If you were following the correct steps, you should have documented everything all the way through this health insurance scare, and if you have that extra documentation you can use it in your favor. Perhaps you could even hire a lawyer. Whatever you do, go into your appeal confident that you will leave a winner, because if you don’t, you could lose the nerve.

If you really want to get your health insurance claim approved, you should try to get your doctor involved. Sometimes health insurance claims can be denied because the treatment or procedure is considered not needed. In order to fight this claim, you can get help from your own doctor, who can contact the insurance company and provide reasons for why it really was necessary and should be covered.

Cheers,

Fashun Guadarrama.