Health insurance claim denials can feel like an unexpected punch, especially when you’ve done everything by the book—visited the doctor, submitted the paperwork, and assumed your coverage had your back. But a denial isn’t the final answer. It’s just the start of a process that, with persistence and knowledge, you can navigate confidently. You and your team have rights under the Affordable Care Act, including access to a full explanation of benefits, the ability to appeal, and the option to request an external review by an independent third party. The real power lies in documentation—log every interaction, gather every relevant record, and stick to the official appeal process. This paper trail becomes your leverage. If an internal appeal doesn’t succeed, you can push further with an external review, especially in high-cost situations involving major procedures or medications. For business owners and HR leaders, this process isn’t just personal—it’s part of supporting your employees through the benefits you’ve promised. Offering guidance through denied claims strengthens your team’s trust and well-being. You don’t need a legal degree to stand up to insurers. With a clear understanding of your rights, a sharp eye for detail, and persistence, you can challenge denials—and win.
source: https://thebenefitdoctor.com/how-to-stand-up-to-your-insurance-companys-denial/
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