According to Consumer Reports, insurance companies can withhold payment after a procedure or treatment is done even if they had previously approved the procedure or treatment. If the insurance company concludes that whatever you had done was not medically necessary, based on information uncovered after the procedure was performed, they can deny the promised payment. Dr. Marvin Lipman, a chief medical adviser to Consumers Union, states that medically necessary is “an iffy sort of qualification that can usually be verified by your physician.”
If the insurance still refuses to pay the claim, patients have the right to dispute the company’s decision. For more information and tips for dealing with denied insurance claims, please visit http://www.insure.com/articles/healthinsurance/claim-denial.html or http://www.fool.com/personal-finance/insurance/2007/01/25/fight-for-your-rights-health-insurance-claims.aspx.
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