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New rules make it easier to appeal health claim denials

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in Human Resources

Regulations released last month by the U.S. Department of Labor guarantee people the right to appeal health insurance claims denials directly to their insurers—and then, if necessary, to an external review board.

Most states already guarantee external appeals, but their rules vary widely and five states have no such laws. The rules take effect next July in states with existing laws.

Are appeals worth the effort? A new study says consumers in New York state last year were successful 47% of the time they filed appeals to reverse a health insurer’s denial of coverage.

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