State insurance commissioner rolls out online tool to appeal health insurance denials

The State Office of the Insurance Commissioner has rolled out an online appeals guide for people who have had a health insurance claim denied.

The State Office of the Insurance Commissioner has rolled out an online appeals guide for people who have had a health insurance claim denied.

“Washington is the first state in the country to provide a detailed online guide for consumers on how to appeal a health insurance denial,” Insurance Commissioner Mike Kreidler said.

Kreidler said his office has provided guidance to thousands of consumers on their rights, but this new guide gives a more detailed blueprint of the steps to take for successfully appealing a health insurance denial.

The new online appeals guide will be translated in Spanish and Chinese and will be presented to community health clinics, senior centers, health fairs and business organizations across the state in the coming months.

The appeals guide was produced with funds awarded by the U.S. Department of Health and Human Services under the Affordable Care Act and will be updated regularly as laws and regulations change.

The online guide can be accessed at www.insurance.wa.gov and on the front of the site is the link titled “How to appeal when a health insurer denies a claim or rejects a procedure.”

The site lists a series of steps to decide if a denial can be appealed.

• Step 1 – Identify your plan and status.

• Step 2 – Learn who regulates your health plan and what to do once you’ve decided to appeal.

• Step 3: The appeal process – before and after health care reform.

• Step 4: Increase your chances of winning your appeal

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