claims denials

Latest Headlines

Latest Headlines

Many consumers surprised at insurance bills, report finds

Almost 33 percent of individuals enrolled in a private health plan have received surprise medical bills in the past two years, according to a new survey from Consumer Reports.

Medicare faces huge backlog of claims appeals

Medicare officials must work through the program's huge backlog of appeals claims, which is currently taking more than 500 days, senators said during a hearing on Medicare audits and appeals Tuesday.

'60 Minutes' accuses insurers of denying mental health claims

The news magazine 60 Minutes said on a recent show that insurers are denying mental health claims for patients in need of chronic long-term mental healthcare. In fact, the show said Anthem had more than a 90 percent denial rate for mental health claims, according to CBS News.

Insurers push back against docs' 'Rolls Royce' treatments

As insurers increasingly deny treatment provided to members that they deem isn't medically necessary, some industry experts worry how there is no specific standard in the Affordable Care Act that states who determines what is a medical necessity, reported the  Los Angeles Daily News.

Consumers usually win when they appeal claim denials

When consumers challenge a healthcare service their insurer denied, they win about half the time, data from California insurance departments show.

State attorney general wants feds to investigate Humana claims denials

The Centers for Medicare & Medicaid Services should investigate Humana for repeatedly denying legitimate claims and overcharging members, the Minnesota attorney general announced on Friday.

Anthem owes providers $3M for underpaid claims

Anthem Blue Cross has agreed to pay $3 million as part of a settlement with the California Department of Managed Health Care regarding claims it underpaid between 2007 and 2011.

NAIC: UnitedHealth improves claim payment process

Insurance regulators are no longer monitoring UnitedHealth's claims payment practices after they concluded the nation's largest insurer has met all requirements under a settlement agreement.

Health Net illegally denied doc-ordered care, lawsuit says

Health Net has illegally denied patients' medical treatments even though they've been ordered by physicians, according to a lawsuit from the Los Angeles County Medical Association (LACMA) and two patients.

Aetna reimburses transgender member for mammogram

Aetna has reimbursed a transgender female for a doctor-recommended mammogram she underwent two years ago, reversing a previous decision to deny coverage. Beth Scott had a mammogram in 2010, and Aetna...