Even when people pay their health insurance premiums and comply with all of the other regulations and protocols under their policy, health insurance companies still frequently deny claims for benefits. When they deny you those benefits, however, there are some legal options which you may be eligible to pursue.
If you are thinking about appealing a denied health insurance claim in Fort Worth, you need a lawyer on your side who can explain all of your legal rights to you and take action on your behalf. Fort Worth denied health insurance claim attorney J. Price McNamara can review the facts of your denied health insurance claim with you and can assist you with taking the necessary legal steps to help you appeal your claim denial.
If your health insurer, for whatever reason, refuses to pay for medical treatment, services, or medications which are medically necessary, you have a legal right to appeal that decision. In order to appeal this denial, however, there is a certain process that you are required to follow. The first step that you should take is to thoroughly review the language of your health insurance plan to learn what the appeal process is and the exact steps you should take. In many instances, your health insurance policy will require that you draft a letter or fill out a form in order for you to appeal the insurance company’s decision.
In most cases, you will be required to file your appeal within six months after you received the notice that your health insurance claim has been denied. After you have exhausted all of the requirements that are part of the insurance company’s internal process, you may be able to have the decision reviewed by an independent review organization, also known as an IRO. Once you submit an appeal, the IRO is then required to make a decision within 20 days, for non-emergency treatment cases, and within five days where emergency treatment was involved.
In addition to these requirements, you should make sure to keep copies of all letters and other information pertaining to the insurance company’s denial of your claim. Documentation to keep includes all Explanation of Benefits (EOB) forms, notes from any conversations which you had with an insurance company employee about appealing the company’s decision, and copies of any documentation or other information which you sent to the insurance company about your appeal.
Attorney J. Price McNamara of the Law Offices of J. Price McNamara can assist you with appealing a denial of your health insurance claim and ensure that all of the necessary documentation is filed in a timely manner.
To schedule a free legal consultation and case evaluation with a denied health insurance claims attorney in Fort Worth, contact us online today so that we can discuss your legal options with you.
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