Health Insurance – HMO was Denied, Can my Doctor Help for an Appeal?
Reader’s Question:
My HMO denied my request. Can my doctor change the decision of my health insurer in Reno Nevada NV?
Theovalerie
Reno, NV
A doctor may appeal the decision on the patient’s request. However, the process to get a health insurance company to change such decision is quite a tedious and troublesome process.
Doctors and health insurance companies in Reno Nevada NV might have a rocky relationship at that. Much of the tension is caused by the hassles doctors encounter when it comes to HMO denials. The potential for HMO’s to deny a request have risen to the point of doctors actually misrepresenting their patients, just to get approval. This could be coupled with the hassles surrounding the denial. A doctor can appeal the decision if a patient’s HMO denies their request. The process done just to get a health insurance company reverse their decision can be a very troublesome one.
Studies have shown that doctors will be more willing to lie about their patient’s medical condition to get them approved especially if their case is considered severe. This can also be true when there is a high likelihood that an appeal will be denied. If the appeal has a higher probability to be accepted, doctors and physicians will be less prone to stretch the truth when it comes to medical records and conditions. The more likely the HMO should deny insurance coverage, it will be more likely that a doctor will consider lying about the patient’s condition.
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