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The Folly of Trying to Map Out the Appeals Process for Insurance Denials

Dozens of experts said building a tool for navigating insurance appeals would be impossible

United statesNew mexicoSan diegoUniversity of southern californiaNew yorkDomna antoniadisKaren pollitzBarbara mcanenyJames swannAbbi coursolleJack daileyKaiser family foundationAmerica health insuranceAmerican medical associationNational health law programChildren health insurance programs

How Health Insurers Have Made Appealing Denials So Complicated

Have you ever had a health care claim denied by your insurer? Ever tried to appeal it? Did you wind up confused, frustrated, exhausted, defeated?

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How Health Insurers Have Made Appealing Denials So Complicated — ProPublica

I spoke with more than 50 insurance experts, patients, lawyers, physicians and consumer advocates about building a tool anyone could use to navigate insurance appeals. Nearly everyone said the same thing: Great idea. But almost impossible to do.

United statesNew yorkNew mexicoUniversity of southern californiaSan diegoJames swannAbbi coursolleKaren pollitzDomna antoniadisBarbara mcanenyJack daileyAmerican medical associationNational health law programCalifornia health consumer allianceAmerica health insuranceChildren health insurance programs

Health Insurers Have Made It So Complicated to Appeal Denials That Very Few Do

No lawmakers or regulators in state and federal governments have forced all insurers to follow one simple standard.

New mexicoUnited statesUniversity of southern californiaSan diegoNew yorkKaren pollitzDomna antoniadisBarbara mcanenyJack daileyJames swannAbbi coursolleAmerican medical associationChildren health insurance programsCenters for medicare medicaid servicesAmerica health insuranceCalifornia health consumer alliance

I set out to create a simple map for how to appeal your insurance denial Instead, I found a mind-boggling labyrinth

I spoke with more than 50 insurance experts, patients, lawyers, physicians and consumer advocates about building a tool anyone could use to navigate insurance appeals. Nearly everyone said the same thing: Great idea. But almost impossible to do.

United statesNew mexicoUniversity of southern californiaSan diegoNew yorkBarbara mcanenyJames swannAbbi coursolleKaren pollitzJack daileyDomna antoniadisAmerica health insuranceChildren health insurance programsNational health law programCapitol forumAmerican medical association

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