Studies have found that up to 95 percent of denied health care claims are not appealed.
The Affordable Care Act, or ACA, the law popularly known as Obamacare, gives a policyholder new insurance rights to demand that an insurer reconsider any health claim denial.
Many claims are denied due to:
- Improper coding of the procedure, or other errors on the part of the health provider.
- Care that was performed outside of the health plan’s network.
- Care that the insurer deems was not medically necessary, or experimental.