Colorado woman was denied medical coverage because her name is too long — now bills are piling up. How to fight a denial

The survey found that 70% of those people incurred extra expenses as a result, while 43% said they’re still paying off the medical debt. The majority of denied payments were over $1,000, while many of those surveyed said the debt “made them hesitant to get healthcare again.”

Weinberger Morneault told Moneywise the same, saying she put off doctor’s appointments because “rather than potentially deal with this again, I’ve gone into avoidance mode.”

While no national statistics currently exist for how much medical debt Americans have incurred specifically from denied claims, a ProPublica investigation found that, broadly speaking, “insurers deny between 10% and 20% of the claims they receive.”

Meanwhile, the Consumer Financial Protection Bureau reported that the amount of unpaid U.S. medical debt in collections totals $88 billion and impacts a fifth of Americans. They also warned that debts over $500 can appear in your credit reports if it’s not paid within a year.

And while claim denials can occur for something as simple as a clerical error, research shows that more than two-thirds of Americans are unaware of their right to appeal claim denials.

That’s unfortunate, given appeals can potentially save you hundreds or thousands of dollars in medical costs — if you know how to go about the process correctly.

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How to fight back against a denied claim

A first step in the appeal process is going over your claim denial and your policy to see if you can understand why the insurance company won’t pay.

If, after that, you believe you have an appeals case, experts suggest collecting all of your documentation related to the claim and adding it to a formal appeal that includes your personal info and policy number, claim details, reasons you were given for the denial, and why the medical treatment is necessary. They also suggest you remain persistent in following up.

Others note that a letter from your medical provider could help your appeal case and that you can also ask your insurer to not send the bill to collections until the appeal process is done.

It’s important, too, to be aware of deadlines for appeals, as missing a window of days or months to file could nullify your case before you even get to argue it.

The Centers for Medicare & Medicaid Services notes that if your first appeal is denied, some cases allow for multiple follow-ups. As well, you can opt for an external appeal by a third party to review your claim, or consider a regulatory complaint to your state’s Department of Insurance — which could lead to a closer investigation of the insurer themselves.

Patient advocate groups also help those whose claims are denied navigate the appeals process and sometimes complicated insurance landscape.

Appeals, of course, aren’t always successful. The Commonwealth Fund survey found that only about a third of those who reported appealing a rejected claim got the decision reversed or the amount owed eliminated.

Weinberger Morneault noted her frustration with the appeal process she’s endured, but did offer some firsthand advice for those looking to challenge a claim denial.

“Keep notes, document everything, and put on your boxing gloves,” she said. “Persistence may be your friend.”

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This article originally appeared on Moneywise.com under the title: Colorado woman was denied medical coverage because her name is too long — now bills are piling up. How to fight a denial

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