Understand medical denial in order to be proactive with your case.
Medical denials come in various forms from the type of denial to the party making the adverse determination. There are also different types of payors including the government such as Medicare, Medicaid and TRICARE, commercial such as Aetna, Cigna and United, private such as Blue Cross Blue Shield, as well as other types of payors. All of these have different appeal rights and requirements. This video reviews these types of payors and discusses coverage decision vs. claim denial, due process concerns, and the importance of analyzing and compiling a response to an adverse decision.
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