Original Medicare, Medicare Advantage, and Part D plans can deny coverage for a health service or medication. However, individuals have a legal right to appeal the decision if they think it is incorrect. A person can submit an application form with a statement, as well as some supporting evidence, outlining why they disagree with Medicare’s...
Victoria Stern January 17, 2023 “Is this really the hill you want to die on?” asked Rebecca Shatsky, MD, a medical oncologist at the University of California San Diego. It was November 18 and Shatsky was on the phone with a retired oncologist working for the health insurance company Premera Blue Cross. Shatsky was appealing a prior authorization denial...
by Tom Murphy Patients are often shocked when their insurance company denies coverage for a procedure or treatment, especially if that leads to a bigger-than-expected bill. These rejections can be fairly common, and people may not put up their best fight to get the decision reversed. Odds are tough, but denials can be resolved with phone...
