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Especially when you consider that these claims are not being made by random people but by trained board certified physicians whose entire livelihood depends on them providing prompt and appropriate care for their patients.
I feel like even 16% being rejected is very high
Well, the claims are reviewed by physicians but they’re often not in the specialization of the care provided so they can make mistaken judgements and a great way to appeal it is to ask the insurance company for proof that the physician who denied the claim does specialize in the type of care being reviewed.
Unfortunately most people don’t know that, less than 1% of denied claims are appealed.