Financial / Tax info

Generally there are a few different ways for a person to challenge an insurance decision that they disagree with. First, most insurance companies have an internal grievance or appeal process that customers can use to challenge determinations that they disagree with. The process for this should be spelled out in the documents provided by the insurance carrier. There may be deadlines on when a person can file a grievance so someone thinking of challenging a determination should pay attention to the fine print on any statements or notices they have received from their insurance carrier. We do not have any information about appealing an insurance decision on our website so I looked around and found more information about filing an internal appeal through healthcare.gov, here, https://www.healthcare.gov/appeal-insurance-company-decision/internal-ap…

The other option that someone may have when they disagree with an insurance decision is to file an external claim. An external review takes the decision making process out of the hands of the insurance company and allows a neutral third party to review the situation and make a decision as to whether or not the insurance company should pay the claim. According to healthcare.gov an external appeal must be filed within 60 days and only certain claims are eligible for external review. For more information on external reviews and the process you can visit, https://www.healthcare.gov/appeal-insurance-company-decision/external-re… Please know that WomensLaw is not affiliated with these websites and cannot vouch for the information contained in those sites. We provide them for your information only – you may want to verify the information with a lawyer in your state.

I also found a more thorough guide for navigating the appeal process that was developed by the Patient Advocate Foundation, you can find the guide here: http://www.patientadvocate.org/requests/publications/Guide-Appeals-Proce… Again, please know that WomensLaw is not affiliated with this website and cannot vouch for the information contained in it. We provide it for your information only.

Also, if you are looking for further assistance in handling this appeal, some legal services organizations may provide free or low cost health care advocates for eligible people. On our website we have a list of legal organizations who assist survivors of domestic violence, many of those organizations are legal services organizations that may offer other services, including a health advocate, or may be able to provide referrals to an organization that does. If you can afford a lawyer then a lawyer referral service may help you find a lawyer who has experience in this area of law, you can locate the lawyer referral services in your state. Here is a link you can use to help you find a lawyer in your area: LINK TO FINDING A LAWYER