Time In Pennsylvania :A New1Insurance Tool Challenge Denials
Pennsylvania offers a new insurance tool that lets customers challenge denials.
A new online resource in Pennsylvania assists consumers in resolving conflicts with their health insurance provider.
It was designed to make it simpler for people to ask for a state review in the event that they feel their claim has been unfairly denied.
According to the state, too often, customers just accept their health insurance companies’ denials.
Pennsylvania Deputy Insurance Commissioner Shannen Logue stated, “We saw a very small number of people who were actually challenging them, but when they did challenge them, it did look like they’re getting a significant number of those denials reversed.”
The number of claims being turned down is steadily increasing; in 2020, 1.29 million claims were turned down. 2 million in 2022
Just 2,165 of the 2 million denials in 2022 were appealed, and an astounding 1,149 of those were reversed. “I think that’s one thing consumers should know is that, you know, we’ve got their back,” stated Logue.
This week, the Pennsylvania Insurance Department unveiled a new tool designed to simplify the appeals process for customers.
Pennsylvania Time
It’s an independent appeals process run by the state that anyone can submit to be reviewed via a newly created, user-friendly website.
“After they complete what’s called an internal appeal, so they’ve already gone back to their insurer, the insurer still denied it, they have the opportunity to now log a request online,” Logue explained.
“We’ll have more people getting the services and health care that they need,” Logue stated. There is an independent appeals program in New Jersey as well.
Pennsylvania also declared on Tuesday that the Pennie enrollment deadline has been extended to January 19.
Pennsylvania’s health insurance market is called Pennie. Currently, nine out of ten enrollees are eligible and can save $500 on average per month on health insurance plans.
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