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, what do I need to do now to
get them 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 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 commissioners office at:
Insurance Commissioner
State of Iowa Insurance Division
300 Maple
Des Moines, IA 50319
515/281-5705