Based on data furnished by health insurance plans, an average of 18% of claims are denied. Why so many?    In a perfect world, all of our medical treatment and prescription claims would be covered by our health insurance plan.  However, Kaiser Family Foundation's review of claims data furnished by over 140 health plans who cover individuals through Healthcare.gov plans found a different story.   Medical necessity, contractual reasons, lack of authorization or referrals and eligibility gaps are common reasons why claims get denied. But did you know that administrative or clerical errors cause the most types of denials?    And only 1/10th of 1% of claims are even appealed.   This podcast takes a closer look at these denial reasons and serves up some action items you can take to protect yourself against paying for denied claims.  
Go to  www.maximizehealthinsurance.com to find resources and other supporting materials discussed in this and other podcasts.