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Understanding Claim Denials
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Claim denials are a frustrating part of healthcare, as they delay care and can require tedious back-and-forth with insurance companies and doctors. But, with about 15% of medical claims being denied each year, it’s likely you’ll face one at some point. A claim denial happens when an insurance company refuses to pay for a requested service, procedure, or medication. Common reasons for them can include missing information when the claim was submitted, duplicate claims being filed, services not being covered by your insurance, and sometimes insurance companies simply denying them to avoid paying. But, it’s important to know that some denials can be overturned. If your claim is denied, contact both your insurance company and healthcare provider to understand why and whether anything can be done. Persistence is key—keep following up until you get a definitive answer.
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