How to Fight Health Insurance Denials

Get rid of insurance companies

Quit believing the lies originated and perpetuated by the insurance companies - we need single payer now! EVERY developed country in the world EXCEPT us has single payer health care. It is good for the economy and it is good for the people. The only ones it isn't good for are insurance companies. They are interested in ONE thing, NOT paying claims. Every claim they don't pay adds to the obscene profits they bring home.

It is nothing more than pure common sense.

Do not believe the lies about Canadian health care - they are ALL lies. Do not believe the lies. You are feeding into the profit motive of U.S. insurance companies. Get smart and do REAL research, not talking head research and not lobbyists paid for research.

Cheryl Fontaine of WA @ Sep 16, 2009 09:57:51 AM

Carol of MI

I had to make two trips to the Mayo Clinic in Minnesota and fully a third of the cars in the parking garage had Canadian plates on them-and you want the same government health plan as Canada has?? Where is your head!! Canadians are praying Obama Care falls flat or they will not have any place to go and will have to wait past death for treatment-if it is aproved. The government can't run anything else, what makes you think they can run health care? Fix what is broke in the present system.

Carol J Lyon of MI @ Sep 15, 2009 21:58:08 PM

"Presumptions"

I bet it was a "great day" when insurance companies signed up to cover us and make us well. Well, things have changed and the CEO salaries are over the TOP... http://sickforprofit.com/ceos/

I fight all "denials" from the "Dr. Zeus", who never met me, never saw my condition, nor reviewed the tests of same. I'm certainly NOT in favor of a "FOR PROFIT" insurance company!

With that said, I'm not going to PRESUME that a government run health system to compete with the "aforementioned", will be good or bad UNTIL we have the opportunity to experience it ! Where do people "get off" with all these negative presumptions? Huh? Negative and untrusting attitudes will never result in any kind of progress, whether it be what we like, versus what we don't.

Let's give our ideas a run for it?

Roger A. Rankin of CA @ Sep 15, 2009 12:51:48 PM

I agree with D of Little Rock, AR

You are correct. It is the doctor that determines what is necessary and what is not. If it is "optional", then you doctor needs to tell you that and ask you if you still want it done. And furthermore, if the insurance company goes ahead and pays it, and then later comes back after one of their internal audits and says they want an overpayment payed back to them, DO NOT DO IT! I had this happen and the insurance company will do everything including sending your case to their collection agency. Don't repay the overpayment! Fight them!

When it comes to the state insurance office for complaints, forget it. In Michigan they tell you its a 6 week process. My last one filed this year in January took 6 MONTHS! And then, even though they admitted I was right, they said there was not enough specifics in the law to hold the insurance company accountable. This office is worthless in my estimation. Go ahead and try it if you want, but I think you are far better off fighting insurance companies yourself. Wait them out, don't get impatient. One of my fights several years ago took 2 years, but I finally won.

Jeff of MI @ Sep 15, 2009 12:45:27 PM

Marl You Lie

Marl, you lie like a rug. Vets are happy to have healthcare benefits from the VA. They don't have to argue when it comes to getting eye exams or drugs. My cousin donated free optometric services for 4 months in a VA hospital in Columbus...nothing but appreciation was expressed by every vet that she met.

No wonder Cleveland is doing so badly...they've got idiots like you.

Max of OH @ Sep 15, 2009 12:23:24 PM

D of Little Rock

I work insurance denials for the physicians in a major hospital. If a physician performs a test or procedure on a patient that the insurance company denies as not medically necessary, the patient IS NOT responsible for the charges. You are not required to know what is medically necessary and what is not - you leave that decision up to the physician, and if he performs a test or procedure that is not medically necessary (as deemed by your insurance company), that is his choice and his responsibility. He (or she) can fight it out with the insurance company in order to get paid, but you are not responsible!

diane of AR @ Sep 15, 2009 12:16:58 PM

I rather fight with an insurance company

I'd rather fight with an insurance company than to go against a federal bureaucrat. That's what Obama's plan will do for us. If you think the insurance companies are stingy, just wait until the government gets into it . . .have you ever hears about the VA and the problem our veterans have getting basic humaine care?

Public Heath Plan Option

Go President Obama. This posting and the comments are exactly why we should have a single nationalized health plan. The insurance companies deserve to be put out of business. They are simply evil money thieves.

Marl in cleveland of OH @ Sep 15, 2009 11:46:40 AM

I pay cash for my health visits...

I have a high-deductible plan ($5500/year deductible) so I basically pay out of pocket for all my medical expenses.

I've noticed a trend with doctors and hospitals, if you offer to pay cash they will often knock off 40-50% of the bill! They are willing to accept HALF of the bill to not have to fight with insurance companies to get their money.

There is definitely something wrong with our system. Unfortunately a public health option will never become reality. The private health industry has too much money at stake, they will never let it happen.

Our basic health and safely should not be in the hands of a "for-profit" company. The US is the only industrialized nation in the world to not offer a public health option. Our school systems, firefighters and police officers are all publicly funded organizations put in place to educate and protect our country. Why should someones basic right to good health care be any different?

It is a very sad state of affairs right now. My wife and I often talk of moving to Canada or anywhere in Europe just so we have a better quality of life when it comes to health care. We want a system that wants us to be healthy, not one that makes money off us when we are sick.

Max of MI @ Sep 14, 2009 15:45:49 PM