When coverage for a claim is denied by your health insurance company, we take definitive steps to address the problem. We scrutinize your policy certificate. We investigate to ensure that the claim has been properly submitted to the insurance company by the medical billing personnel. We review policy documents to determine the nature and timing of your appeal rights. In most cases, you have the right to have a denial of coverage reconsidered by your health insurance company or to engage in a more formal appeal.
We compile and review necessary correspondence, clinical, medical billing, health, and insurance records. When appropriate, we contact your physician(s), hospital, and other providers. After a thorough review of all materials, we may seek reconsideration and/or prepare an insurance appeal on your behalf.