Among the items on recent list of things your health insurer won’t tell you was the fact that you shouldn’t give up if your insurance claim is initially denied. Now a new report from the Government Accountability Office says that upward of 50% of appealed claims ultimately get paid.
While the GAO was only able to study a few states for its report, in both Maryland and Ohio, nearly 50% of appeals led to reversals in 2009.
But the GAO is quick to caution that these findings don’t imply that every denied claim has a 50% chance of being reversed. Appealed claims were only a small portion of the total number of denied claims.
One of the most frequent reasons for claims being denied is an error in the billing code.
“You’ve got a lot of people in America who are ultimately paying a bill they don’t owe because they don’t realize it’s an incorrect code,” the CEO of Patient Advocate Foundation, a nonprofit that helps people appeal claims denials, tells the Associated Press.
So if you truly believe that your claim was denied because of a billing error or other mistake, don’t be afraid to challenge the insurer. As a number of you pointed out in the comments to the earlier story, it’s sometimes the only way you were able to get coverage.
Study: Many health insurer appeals work [DetNew.coms]