Sometimes, insurance companies deny claims for treatments or medications. When that happens, you have the right to appeal the decision.
It always helps to be organized in your dealings with your care providers and your insurance company. That requires taking a lot of notes about your conversations and keeping well-organized files. Here are a few tips:
- Learn the plan's rules. When are references needed from the primary physician? Are brand-name drugs covered? Are there conditions or services that are not covered?
- Every time you communicate with the insurer, date your documents and make copies of them.
- Whenever you talk with your insurer, get the full name of the person you are talking with, take notes, date them and file them.
- When an insurance company representative promises you a service, ask them to put it in writing and send it to you by mail or e-mail.
- Maintain a file for all your medical records.
- Highlight sections of your insurance plan that pertains to CF.
- Ask your insurance company to assign a case manager to assist you.
When coverage is denied, it is time to file an appeal with the insurer. Call the company and find out why coverage was denied, then find out what the appeal process is and follow it.