How to Advocate for Yourself After a Health Insurance Claim Denial
August 7, 2024
Life is full of unexpected twists and turns. The denial of your health insurance claim by your insurance company is one of those instances. If you have paid your insurance policy premiums on time, you would expect that your claim would be paid fully, and in a timely manner. Receiving a letter of denial would not be something considered possible. Unfortunately, actions like this are not uncommon -- insurance companies deny claims every day. In situations like this, controlling what you can is a valuable mindset to adopt. You cannot control what has already occurred, but you can control how you react. Knowing what to do to appropriately advocate for yourself, your health and your future is incredibly valuable. Consider speaking with an experienced denied health insurance claims attorney for guida... Read more
Pre-Authorization Blues: What to Do If Your Insurance Denies Coverage For a Planned Treatment
For reasons many find hard to comprehend, insurance companies in Oklahoma and across the country deny coverage for necessary medical treatments every day. Because insurance companies are businesses with goals of profitability, actions like this that minimize expenses and benefit their shareholders makes sense. Unfortunately, denying pre-authorization requests for necessary medical treatment puts their policyholders in precarious positions; they are unable to receive the medical treatment they need. Sometimes, even when you, as a medical insurance policyholder, do everything right, including requesting the necessary pre-authorization, you still don’t get the answer you need. The good news is that you do not have to accept the insurance company’s first response as final. Consulting with a seasoned ... Read more
Denied Coverage for Mental Health? Here’s How to Challenge Your Health Insurance Company.
July 22, 2024
Mental Healthcare Is Often Misunderstood Every day individuals in Oklahoma and across the country receive word from their insurance companies that their mental healthcare claim was denied. This is a longstanding problem, although things are much better today than they have been. Yet, when it comes to mental health benefits, claims are still regularly challenged. Those whose benefits are denied are saddled with significant costs, and many are simply unable to get the treatment they so badly need. The barriers to mental healthcare are frustrating - and significant. It is important to realize that mental healthcare is just as necessary as care for the physical ailments from which many suffer. In fact, the government recognizes that “mental and behavioral health services are essential health benefit... Read more
Negotiating with Your Insurer After a Denial: Tactics that Work
July 19, 2024
Doing Things Right Makes a Tangible Difference If you have received a letter of denial regarding your insurance claim, you are not alone. Health, automobile, and property insurance claims are denied every day in Oklahoma. Unfortunately, this likely provides little comfort. You need your claim to be honored to pay your bills. Without it, you may be forced to make difficult decisions, including assuming overwhelming debt to pay your expenses. In some situations, you won’t be able to repair your home or vehicle; in others, you cannot obtain the medical treatment you or your loved one needs. Insurance claim denials are more than inconvenient; they can be life-changing. Many who don’t realize that appeal options exist take their insurance company’s initial denial as final and assume the financial bu... Read more
5 Essential Documents to Strengthen Your Auto Insurance Appeal
June 21, 2024
Has Your Automobile Insurance Claim Been Denied? If you answered yes to the question above, rest assured you are not alone. In fact, insurance claim denials happen every day. Those who submit their covered claims in a timely fashion, and in accordance with the parameters outlined in their policies, expect them to be paid appropriately. Yet, policyholders in Oklahoma and across the country receive denial notifications every day. In situations like this it is important to recognize that as a policyholder, you do have recourse. There are steps you can take to appeal your claim and receive the reimbursement to which you are entitled. After all, if you do not appeal your claim, you are assuming responsibility for all of the costs associated with your accident - a situation that can be financially devastating... Read more
Emergency Room Surprise! How to Fight a Denied Claim After an ER Visit
June 11, 2024
Emergency Room Insurance Claims Are Frequently Denied ER Visits Can Be Expensive Nobody wants to go to a hospital emergency room. Unfortunately, life is unpredictable, and when serious medical needs arise an ER is often the best place for treatment As a result of the services they provide, including immediacy of care, emergency rooms are often the most expensive places to be treated for illness or injury. The high cost of emergency room visits is particularly problematic for insurance companies burdened with the costs for their policyholders. Because of the urgency of necessary treatment, most emergency room patients are only aware of the costs of their care once they receive the hospital bills. There is often no time for pre-approvals and treatment is provided immediately, as needed. Becau... Read more
How Do Health Insurers Decide If Treatment is Experimental or Investigative?
May 6, 2024
Medical Treatment Is Ever-Changing If you watch the daily news, you know that advances in medical treatments for a broad range of illnesses occur regularly. Researchers across the country and around the world work diligently to identify cures for diseases and treatments to alleviate the devastating effects many who are affected suffer. Each discovery is met with joy as it provides hope for those who are ill and their families. Perhaps nothing is as disappointing as having a health insurance company deny your claim stating the treatment is either experimental or investigative. Those who receive these notifications may be paralyzed with fear. Their physicians finally identified a treatment that could help, and now the insurance company will not approve payment. Because the price of medical treatment is o... Read more
How to File for an External Review of Your Denied Health Insurance Claim in Oklahoma
April 26, 2024
External Insurance Reviews Provide Hope Denied health care claims have, unfortunately, become commonplace, both in Oklahoma and across the country. In a never-ending effort to remain profitable, health insurance companies regularly delay, underpay, and outright deny claims, leaving individual policyholders unable to get the treatment they need or saddled with astronomical medical bills. If your health insurance claim has been denied it is important to recognize that the decision may not be final and that you do have recourse. The processes for internal appeals and external reviews can be complex. Insurance companies engage teams of individuals, including legal professionals, to minimize their expenses by defending their actions. If you are struggling with inappropriately paid claims, engaging lega... Read more
What Damages Can I Recover From an Insurance Bad Faith Case?
April 15, 2024
Bad faith actions by insurance companies are an unfortunate reality of today’s world. Every day these organizations make decisions that are not in the best interests of their policyholders; they are also simply unfounded and based on information designed to minimize reimbursement, therefore maximizing corporate profits. In short, their loyalties lie with their shareholders, not their policyholders. In Oklahoma, insurance companies are required to act in accordance with the terms outlined in the policies they issue and in good faith. This means that policyholders have legal recourse when claims are unfairly denied; insurance companies can be held liable for their bad faith actions. Those who were wronged may be entitled to settlements designed to compensate them for their losses. Understanding the D... Read more
Fighting Your Health Insurance Cancellation
April 12, 2024
Every day individuals living in Oklahoma receive notice that their health insurance policy has been canceled. Messages like this are frightening; we all rely on our medical insurance to protect our financial and personal well-being if and when we get sick. Not having coverage leaves our health at risk and our future vulnerable to the exorbitant costs of medical care. If you have been notified of a health insurance policy cancellation, you must take action. The reason for the cancellation can guide your actions going forward. Knowing what to do and how to do can be confusing. In many cases, working closely with a health insurance cancellation attorney can prove valuable. These professionals understand the laws governing insurance and know how to address issues as they arise. You want to approach this ... Read more