Los Angeles Anthem Health Insurance Denial Appeals Lawyer

You believed you followed all of Anthem’s rules and regulations when it came to receiving medical care and submitting your claim in Los Angeles. You also paid your premiums on time. Then one day, you receive a claim denial letter. You may be shocked, worried, and even angry. You may also be wondering if there is anything you can do or if you simply need to accept Anthem’s decision regarding your claim.

By contacting a well-versed Los Angeles Anthem health insurance denial appeals lawyer, you can appeal your claim. A dedicated attorney can work with you to help you advocate for your rights to get you the coverage you need.

How Anthem Benefits from Claim Denials

Health insurance companies, Anthem included, are in business to make money. When they continually pay on every claim they receive, their bottom line may be negatively impacted. Therefore, insurance companies will often find every excuse to deny claims, especially large ones. For the millions of Anthem policyholders who faithfully pay their health care insurance premiums each time they are due, this can be quite infuriating and worrisome.

When they want to deny a claim, Anthem has a plethora of reasons to choose from. The most common reasons for a claim denial include:

  • No proven medical necessity for the service or medical device sought
  • The service sought is investigational or experimental
  • The deadline to file the claim has passed
  • The insured received two medical services in one day
  • The out-of-network benefits are different from in-network benefits
  • The insured did not reach their deductible
  • The policyholder made a late payment to COBRA
  • The insured had a certain medical procedure that was not covered or not pre-approved

Insurance Law for Appeals in Los Angeles

After a claim is denied, the insured has options. As per California Insurance Code Sections 11737(F), 1753.1(A) And 11753.1(B) insurance companies must give the insured an opportunity to appeal a denied claim. This appeal is an opportunity to have the claim seen by a different party and to be sure all the pertinent information has been included.

Consulting with a Los Angeles Anthem health insurance denial appeals lawyer may give claimants the best chance of having their appeal approved by Anthem. Their attorney can guide them through the process to help them get the coverage they need.

Speak to a Los Angeles Anthem Insurance Denial Appeals Attorney Today

You do not need to accept a claim denial. Anthem policyholders who believe their claim for medical services was wrongfully denied due to one of the aforementioned reasons or for any other reasons should contact a Los Angeles Anthem health insurance denial appeals lawyer.

An experienced Anthem insurance attorney can help determine whether your denial was valid, and, if it was not, can take action on your behalf. An attorney who is well-versed in California insurance laws is not afraid to face Anthem when they have treated a policyholder unfairly. Call today to learn more about fighting claim denials and appeals with Anthem.

Los Angeles Anthem Health Insurance Denial Appeals Lawyer