Denied Insurance Claims

Q: I was treated by a chiropractor but my insurance company has denied my claim. I feel that my treatment was legitimate, what can I do to get my insurance company to pay the claim?
 A: You and/or your chiropractor have the right to go back to your insurance company and ask them to do an internal review of your claim to see if they will change their original decision and pay the claim.
 
 
 Q: I have asked for an internal review from a denied claim and they still denied it. I still feel my treatment is legitimate and that the insurance company should pay for it.  Now what can I do to get the insurance company to pay my claim? 
A: If the internal review of your claim has been denied you may have the right to an external review. To find out if you can request an external review in your state, contact your state insurance commissioner.
 
In the state of Iowa a Patients’ Bill of Rights law was passed to establish a mechanism to use an impartial third party to review the medical necessity of denied claims. If you live in Iowa and wish to appeal a claim that has been denied through an internal review contact the Iowa Insurance Commissioner's office at:
 
 Insurance Commissioner
 State of Iowa Insurance Division
 300 Maple
 Des Moines, IA 50319
 515/281-5705

For more information on filing for an external review (complaint) go to http://www.iid.state.ia.us/educational_materials/externalrev.asp