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Replies to "Yes, I had difficulty getting my insurance to cover upon first request. We appealed and they..."
Polymyalgia Rheumatica (PMR) | Last Active: 8 hours ago | Replies (73)
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Yes, I had difficulty getting my insurance to cover upon first request. We appealed and they approved. Health Insurers deny around 850 million claims per year, according to health policy non profit KFF. Less than 1% appeal, but a large number who do are accepted. My rheumatologist handled the paperwork.
Replies to "Yes, I had difficulty getting my insurance to cover upon first request. We appealed and they..."
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It's easier for insurance companies to acquiesce to appeals. You really need a strong willed doctor for a successful appeal.
Appeals cost insurance companies time and money and often they are better off paying the claim. If an appeal leads to a lawsuit... pain and suffering can cost an insurance company a ton of money when it is deemed that the treatment is medically necessary.