Health insurance is designed so that those who are insured and pay their premiums will have the assistance of the insurance carrier in covering their medical treatment and paying their medical bills. Many Americans trust and rely on health insurance companies to cover and pay for their healthcare treatment.
However, far too often, insureds are denied coverage and payment for their medical claims. In fact, according to the Physicians for National Health Program, California insurance companies deny 26 percent of all claims they receive. If you are facing challenges in getting your insurance claims covered and paid in Los Angeles, an Anthem Blue Cross of California health insurance denial lawyer could help you.
Just as the insured has a responsibility to pay their premiums and deductibles for coverage, the insurance company is also legally responsible for taking several actions. For example, they must give the insured a written explanation of why the coverage or claim is being denied. Information about how to appeal the denial normally must be included with the explanation. According to California law, failing to adopt and implement reasonable standards for the prompt investigation and processing of claims arising under insurance policies is illegal. Furthermore, Anthem is mandated to have an insurance appeals process for coverage that they deny.
Those who receive a denial letter have a limited time period from receiving the denial to file an appeal, which can be filed by the subscriber or someone on their behalf such as a health insurance denial lawyer who has experience with Anthem Blue Cross in Los Angeles. If a representative will be filing for the subscriber, they must complete paperwork that gives the representative legal authority to act on the subscriber’s behalf.
Our team of skilled Los Angeles health insurance denial lawyers have extensive experience in representing people who have been denied a variety of insurance claims.
Out-of-Network medical coverage can be common during a medical emergency. If Anthem has denied your claim, our team can help.
Often times, insurance companies do not live up to promises and follow through with paying for coverages.
If Anthem insurance has denied a payment to cover a necessary surgery, our skilled Los Angeles health insurance denial lawyers can help.
Unfortunately, many who appeal their denials are not successful. Sometimes this is because the same parties that made the first decision also made the second. However, anyone who has received multiple denials may still have options.
At this juncture, the insured often can choose to appeal a second time to an independent third-party or they can pursue a civil court case. An Anthem Blue Cross of California health insurance denial lawyer in Los Angeles can help evaluate a denial to determine the best course of action.
What many health insurance subscribers do not understand and what many health insurance companies seem to conveniently forget is that health insurance is a contract between the insurance company and the subscriber. This means it is subject to contract law.
It is possible that the court would consider Anthem’s denial of coverage as a breach of contract, therefore, ordering them to pay for that coverage. Speaking with a seasoned Anthem Blue Cross of California health insurance denial attorney can help subscribers understand what their rights are.
To make higher profits, some insurance companies will attempt to deny claims they should be covering. Not only is this practice unfair and unethical, it is also illegal. Patients like you who may already be facing a hardship due to their medical condition must also cope with unnecessary stress due to this practice. Sometimes seeking help can improve the situation.
An Anthem Blue Cross of California health insurance denial lawyer may be able to help get your claim covered. Call today to learn more about how an attorney can help you get the coverage you need for your medical treatments.