Insurance Denials & Appeals

Did You Know?

• Only 1 in 10,000 insurance denials are ever appealed by patients or doctors?
• Only 1 in 3 insurance claims are processed correctly?
• Healthcare prices and billing standards are based on Medicare guidelines?  There are 45,000 pages of Medicare regulations.
• 30% of every healthcare dollar spent goes to error, fraud and abuse?

Most insurance denials are for particular codes not covered, services that are not medically necessary, uncovered charges or out of network. Consumers are told one thing, think another and the outcome is often times incorrect and not in their favor. As a result, consumers are confused, distrustful and most do not have the time or knowledge to battle through an insurance appeal.

We do appeal and we win!

Your Advocate will work with you and your healthcare provider to mount a strategic insurance appeal on your behalf anticipating an end result of getting the procedure covered and the claim corrected. Additionally, the implementation of the Affordable Care Act means that as more consumers enter our healthcare system, the risk for errors increase as new plans come online.

We can help you understand your insurance plan and benefits to use them effectively before you need them so there are no surprises.