Rancho Cucamonga Health Insurance Denial Attorney

Receiving a health insurance denial can be devastating if you have a serious injury or illness and your doctor believes this treatment is the best option for helping you get better. There are no exact figures on how many health insurance claims are denied. Estimates range from 13 percent all the way to almost 40 percent. Since insurers are not required to disclose this information, it could even be higher. There has been more and more news regarding big insurance companies denying claims yet reporting record profits.

Unfortunately, most people believe they cannot fight a large corporation and win. This is far from true. As published in a 2023 study, at least 40 percent of certain appeals are successful, yet only about 1 percent of all those who receive a health insurance denial will appeal. While filing an appeal can be intimidating and complicated, it is worth the time and effort.

Those who involve an experienced Rancho Cucamonga health insurance denial attorney in the process are even more likely to have a positive outcome. Attorney Scott Glovsky has been helping people fight insurance companies that are not living up to their promises for many years. Scott is a strong advocate for those who feel hopeless and helpless after receiving a Rancho Cucamonga, CA, health insurance denial.

Page Contents:

• Why Are Health Insurance Claims Denied?
• What Can You Do if You Receive a Rancho Cucamonga, CA, Health Insurance Denial?
• Which Insurers are Most Likely to Deny Treatments?
• What Are Your Options When Your Insurer Denies Your Claim?
• How the Law Offices of Scott Glovsky Can Help Following a Rancho Cucamonga, CA, Health Insurance Denial

Why Are Health Insurance Claims Denied?

There are many reasons a health insurance claim may be denied. The denial may be due to something simple like missing information, errors in the paperwork, or miscoding. More serious reasons include using an out-of-network provider, missing a crucial deadline, or failing to obtain prior authorization. Some insurers require step therapy for any relatively expensive treatment that the doctor recommends.

This means that other, less expensive treatments must be tried unsuccessfully before the treatment is approved. The insurer may sometimes claim that the treatment is not medically necessary, experimental, or investigational. This usually—but not always—means the treatment is expensive, and the insurer does not want to pay for it. This scenario almost always requires an appeal or a lawsuit if bad faith is at hand.

What Can You Do if You Receive a Rancho Cucamonga, CA, Health Insurance Denial?

If you have received a Rancho Cucamonga, CA, health insurance denial, it is important that you take swift action. You can file an internal appeal, asking your insurer to reconsider the denial. If you include a letter from your doctor detailing all the reasons they believe you need this treatment, the insurer may reverse its denial. You can file an external appeal with a neutral third party if the claim is still denied.

Whatever decision this third party makes must be honored by your insurer. Having an experienced, knowledgeable Rancho Cucamonga health insurance denial attorney like Scott Glovsky as your advocate can be extremely beneficial during the appeal process. Not only can he help your appeal be professionally and comprehensively submitted, but big corporations tend to show more respect to those who are legally represented.

Which Insurers are Most Likely to Deny Treatments?

Virtually any health insurance company can deny a medical treatment, and, in fact, the rates of denial appear to be similar whether the insurance is obtained through an employer or the federal government. Some of the California health insurance companies that could potentially deny a healthcare claim include:

• Anthem Blue Cross
• Blue Shield
• HealthNet
• Kaiser
• Cigna
• Aetna
• Medi-Cal Managed Care Plans
• Others

What Are Your Options When Your Insurer Denies Your Claim?

It is easy to feel as though you have no options after receiving a treatment denial. We have been conditioned to believe that big companies are invincible and that nothing we do will have an impact. This is simply not true. Attorney Scott Glovsky has forced dozens of large insurance companies to sit up and take notice, reversing denial decisions and even changing their behaviors regarding insurance denials.

Scott never hesitates to go up against a large corporation and fight for “the little guy,” which is you. You can file appeals with your insurance company, or when an insurer is clearly exhibiting bad faith by failing to live up to its contract, then Scott can file a bad faith insurance lawsuit on your behalf. You are not helpless and do not have to accept your insurance company’s decision when it denies your claim.

How the Law Offices of Scott Glovsky Can Help Following a Rancho Cucamonga, CA, Health Insurance Denial

Do not give up if you are facing a Rancho Cucamonga, CA, health insurance denial. The Law Offices of Scott Glovsky has helped hundreds of people just like you get the justice they needed and deserved. In addition to dozens of testimonials from former clients, we also have many, many successful outcomes to our credit.

We are proud that our cases have impacted millions of insurance policyholders, forcing insurers to change their behavior, including how they review claims for medically necessary treatment. Our firm has a system that reaps positive results in every type of bad situation. We really listen as you describe the harm you have suffered in your life because of a claim denial, then prepare the facts and the heart of your case.

We apply the law to the facts of your case and then develop strategies and tactics that maximize your chances of a positive outcome. Our firm has extensive trial experience and a history of taking complex cases to trial, so insurance companies take us very seriously. Contact the Law Offices of Scott Glovsky today.