3 ms·

You seriously over-estimate how much people know about their rights and the time they are willing to spend exercising them. But you are right that they should.

• lotsofpulp 6y ago
  That's actually very interesting. Although the article is from Apr 2014, it has some statistics that may be relevant to insurers erroneously denying coverage: https://www.capradio.org/articles/2014/04/01/patients-win-about-half-the-time-they-challenge-denied-health-care-services/ https://www.capradio.org/articles/2014/04/01/patients-win-ab... >Insurers say only about three percent of claims are denied. >California data show about half the time a patient challenges a denied health care service through a third party, the patient wins and gets the health service. If we assume that denied claims that were overturned were erroneously denied coverage by the insurance company, then half is a huge error proportion, one that would make me think the insurance company is doing it intentionally, or at least intentionally not doing it right. But maybe the ones that got appealed are closer to being decisions that could go either way and the ones that don't get appealed are black and white cases that were clearly covered or not covered.
  • alphabettsy 6y ago
    It’s easy to lie with statistics. I’d be willing to bet lots of money that it’s 1% because the vast majority of claims are doctors appointments and other very routine things and that major medical procedures, that are less common though more impactful, make up a disproportionate number of denials.