BC Advantage - 2015 Issue 11

APPEALS expanded under the Affordable Care Act

Your right to appeal a denied claim was expanded under the Affordable Care Act. You can maximize the chances that your appeal will be successful by following these tips:1. Review your EOB - Before you can fight a denied claim, you need to understand why it was denied. Carefully review your Explanation of Benefit (EOB). Check the message or reason codes at the bottom of the EOB. Sometimes your claim was denied only because of a dataentry error like a misspelled name, insurance ID number, or the wrong date of service. Review your claim for errors. If you find...

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