Health Insurance Claim Articles

Health Insurance Denied Medications

By Jeffrey L. Greyber, Esq.

Medical prescriptions can cost patients thousands. Medical prescriptions are more frequently being denied insurance coverage. A possible example includes: a health insurance company attempting to force generic prescriptions on their policyholders, when in fact their medical provider is insisting on name brand prescriptions.

Sometimes a medical provider will prescribe a particular combination of medications, and then your health insurance company's in-house physician, who has never met you, is reviewing your file. The health insurance in-house physician may then determine the particular combination of medicine is not actually medically necessary for you. The health insurance company's in-house physician will then recommend another combination of medicine that costs them ultimately much less.

Another recent trend includes health insurance companies outsourcing their medical coverage to other companies. The complexity in the prescribed medicine arena is only increasing. More and more wrongful insurance claim denials and wrongful insurance claim underpayments are occurring.

Health Insurance Claim Articles