subject: If Your Insurance Company Denies Payment You Have A Right To Fight It [print this page] You may not know it but you have the right to appeal under the Affordable Care Act of March 2010 any decision to deny payment made by your insurance company. With these new rules in effect it can be simple to see why the insurance companies are not very happy with the governments intrusive hands getting into their business.
Independent reviewers will now be watching the health insurance companies and doing the investigating and this means that you now have the right to question your insurance companys right to deny you coverage in any and all instances. In the past these issues have been handled by the insurance companies themselves but now you are going to have a real person who does not work for the health insurance company in your corner.
And the insurance company must not only inform you of any denial but when they do they also have to let you know how to file an appeal of this denial. Once you decide to appeal your plan must provide you with its decision within 72 hours for urgent care, within 30 days for non-urgent care services you have not yet received, and within 60 days for denials for services you have already received. And this faster process is crucial to those who are in the middle of a health care crisis with an insurance company that's refusing to pay for life saving treatments.
You will be allowed both an internal and external review possibly even at the same time depending on the urgency of the situation. And if you dont speak English you should be able to receive information about appeals in your native language as well. Everyone has the right to know and understand their right to an appeal.
The new reform is one that is designed to create a system of Checks and Balances in the health insurance industry and it is designed to benefit both the consumer and the entire industry. In creating a level playing field and helping consumers get the coverage they need and deserve the health insurance companies will have to watch their ps and qs as they deny and pay claims this should be of great comfort to consumers everywhere.
The health care reform may not be perfect but in the end it aims to help you get the benefits that you need from your insurance at the time when you need the help the most. Having these new laws in place should help everyone to get a fair shake from their health insurance company.
by: Ethan Kalvin
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