My claim insurance was denied. What can I do?

If you believe your application was denied inappropriately, there are several things you can do:

* Each insurer has an internal review process. You can find out about the process by calling the number on the explanation of benefits (EOB) document that you received and asking for information on the appeal process for your health plan.
* Many insurers have multiple levels of review. Although it varies by company, most of the time, you can call your request more than once.
* Many health plans are outside independent medical experts who they will ask to review the claims.
* Medicare beneficiaries must follow the procedure described in their manual Medicare. For more information, please visit www.Medicare.gov or call 1-800 MEDICARE.
* Medicaid beneficiaries should call their state Medicaid office for information about the appeal process Medicaid. A list of contact numbers of the state is available here.
* If you have gone through all the processes of internal review of your health plan and you believe your application was refused by mistake, you may have another chance of appeal. 43 States plus the District of Columbia have external or independent review of the programs. This is a review process overseen by the state, which provides an additional, legally mandated appeal. Click here for more information on the program in your state. For a list of frequently asked questions and answers about the external review procedure here.