Sometimes you are in dire need of medical insurance but your provider denies you even though you have been very prompt on insurance premiums.
When you are given the denial, it hits you like anything. You get confused and you dont know what to do. Well, let me help you out in that case.
By law, your insurance provider is supposed to provide you information based on which the claim was denied.
* A statement of specific medical and scientific reason for denial.
* A statement identifying the provision that excludes treatment.
* The name, state of licensing, medical license number, and title of the person making the denial decision.
* A description of alternative treatment, services, or supplies that are covered, if any.
* Instructions for initiating internal appeals of denial, including whether your appeal has to be in writing, time limits, schedules for filing, and the name and phone number of a contact person.
* Instructions for filing an external request for review if the denial is upheld in the internal review.
If you do not receive this information from the insurer, ask for it in writing and you can even go to the court in case they give you a hard time for it.