Your insurance is supposed to take care of problems not cause them, but sometimes you have to take matters into your own hands and file an insurance appeal. Here’s what to do if your insurance refuses to pay for a new treatment or specialist visit.
- Be nice but firm. Call your company’s customer service number and explain the problem. The minute the customer service representative says she can’t help you, ask – nicely – to speak to her supervisor.
- Take notes. Ask for the name and title of every person you talk with, and write down what they tell you, even if it’s just that you’ll need to speak to someone else.
- Call your doctor’s office. Explain that your insurance has denied your claim, and ask your doctor to write a letter to the insurance company supporting your position.
- Send your own appeal letter. Explain how the denial affects your health. Include a copy of your doctor’s letter.
- File an appeal. Every insurance company has an insurance appeals process – make sure you follow it to the letter.
- Call your Congressperson. As a last resort, explain your situation to your federal representative. He may be able to cut through the red tape to get your insurance claim approved.
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