Health

Denied by your insurance carrier? Here’s what you can do about it.

Aetna may not be the only insurer who has denied treatments without ever reviewing cases, says WSB consumer expert Clark Howard.

"All I can tell you is that a lot of people have a problem with denial of payment from insurers, " says Howard. “What you need to know is that the meek do not inherit the Earth in this case.”

It was reported earlier that a medical director for Aetna admitted to denying treatment despite not even reviewing the cases put before him and his team.

It would not be unheard of for abuses to be common in an industry where the financial incentive is to deny payment for services.

Aetna issued a statement asserting that its guidelines are "based on health outcomes and not financial considerations.

WSB consumer expert Clark Howard says , "What you need to know is that the meek do not inherit the earth in this case." He says follow the appeals process and document everything. If you are denied again he says continue the process and appeal again.

If your health insurer refuses to pay a claim or ends your coverage, you have the right to appeal the decision and have it reviewed by a third party.

You can ask that your insurance company reconsider its decision. Insurers have to tell you why they’ve denied your claim or ended your coverage. And they have to let you know how you can dispute their decisions.

“Most insurers count on people saying ‘oh, well I give up’” Howard added. “You don’t give up. It’s your money and you make sure that you advocate for yourself.”

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