Issues with Insurance Company Health Claim Denial

stethoscope
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Issues with Insurance Company Health Claim Denial

stethoscope

stethoscope

Getty Images/iStockphoto

stethoscope

Getty Images/iStockphoto

Getty Images/iStockphoto

stethoscope

Victoria Franz

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Imagine you have found out that you have a serious condition and need specialized medication and testing in order to live, which has been recommended specifically by your doctor. However, you learn that your insurance company believes that this care is unnecessary and “investigational.” These companies are posing an issue for patients who are forced to pay out of pocket if they appeals to the companies fail after their claims are initially denied. Insurance companies are failing to understand that unless proper tests are administered when a patient is taking a medication, it will actually cost the company much more money in the future due to more serious and invasive procedures that will need to be performed on the patient. While a person might argue that the insurance companies have the right to spend their money on the treatment that they feel is necessary, doctors have the right to care for their patients performing the tests that they know are necessary based on their knowledge and extensive research. While it is unlikely that this issue will be resolved in the near future, the end goal is that insurance companies will include that doctors have the right to make decisions for patients without the interference of the companies in their health insurance policies. Therefore, doctors’ decisions should clearly take precedence over those of insurance companies as the doctors have studied medications and testing methods and have devoted their lives to caring for patients, while insurance companies simply deal with the monetary aspect.

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