Fibromyalgia & Chronic Pain LIFE Summer 2013, Issue 9 - Page 31

Navigating Insurance is being done and submitted in a timely fashion. Keep records on all aspects of your health care and treatments. Make and file copies of all your bills and correspondence with your doctors, hospitals and insurance carrier. Denials of claims are often based on processing errors rather than the treatment process. Having your own detailed records can help untangle confusing and incorrect paperwork and claim submissions. • Challenge every denial. Never take “no” for an answer. Denial can be the first response you receive. Every insurance company is required by law to furnish an appeals process to its clients. If appeal information is not offered, request it. Work with your doctors handling your pain treatment plan. Their input is one of the most important assets you have when using the appeals process. A denial could be based on one word that has not been included in the written documentation sent to the claims office. Doctors’ notes, patient charts and records are important in successful reimbursement of your claims. Your claim was denied. How do you appeal the denial? • Statistically, 94% of insurance denials are never appealed, but approximately 70% of health insurance appeals are granted. Obviously, your appeal has an excellent chance of being successful if you are willing to follow through and do extra work. • Most insurance companies offer two levels of appeal. The first appeal is due within 180 days of denial of coverage. The second appeal is usually due within 30-90 days of denial of coverage. This is one reason your record keeping is so important. If you ha ٔ́ѼЁѡфЁ́հѼٔȁ́ɑȸ%хѕ̰ѕɹѼЁɕ٥܁ɝѥ́مѡЁٕɸѡɅ丁Q́ݥѠѡMхє%ɅѵЁѕȁѡѕɹȴ()䁅́ٔᡅѕ$ѕɹ́م丁M䁍ٕȁ!5=ͽ䁍ٕȁѕɵѥ́ѡЁɕѵЁ̃qɥхtMɝ͵ͽɕɸѡԁݥ%͡аѡ䁅ɔͥѕиȁɔɵѥɕɑѕɹ́ȁхєхЁȁMхє%ɅѵЁȁɵѥ=ѱ1ѕȁɅ͡ձՑѡݥ̸$Aѥӊéɥ䁥ɕͽЁѡѥФɅ%յȰͽ͕ɥ䁹յȰєѠ$Aѥӊḛ́ͥՑѥٔЁ̰ͥ́ɕɑ̸$Qɕѵ́ѡЁٔɥٕȁɥѥMхЁݥѠє͍ͥ́ɥɕѵ́ѡЁٔɥͥѡЁѥ$Mյ䁽ɕمЁѕɅɔՑ́ѕɅɔم$Qɕͽ́ݡѡѥЁٕ́ѡѡɅ䁽ȁ͕٥́ɽɥєȁѡȁѥ$Qȁѡѥӊéɕ͔Ѽɕѱ䁍ɕєѼѡɕˊéɕͽȁ%ͥ܁ѡ́хЁ٥ٕѡ՝ѕȁ٥ѕ́ԁѼѥє䁍ѡɅ䁅ɵѡȁѕѥѼٕȁȁ͕єѼѡɕȁݥѡЁɕɑ́ѡȁյхѥ%ѕɕɔȁͼѡЁѡɕȁ́ЁݥѠՕѥ́ѱЁѼɅЁȁٕȁѡɕѵЁԁɕեɔ()MյȀ́ɽ共 ɽA()1NJ((0