Rukavina recommends asking the insurer to send you information to support its denial, including name and credentials of the employee who reviewed it as well as specific records he reviewed. You'll want a description of any of your medical records necessary for treatment approval and copies of expert opinions the insurer relies on when reviewing that treatment. Also, ask for the name and address of the appropriate person or department to send appeal letters, he says. And, send them by certified mail.
Whom can I call on the state level for help?
If your insurer refuses to budge, it's time to get the government involved. You can contact your state's department of insurance, although Weil recommends asking your state attorney general's office if it has a health care bureau.
"Many states have them and they'll call the insurer on your behalf. They can be effective in getting the insurer to reconsider," she says.
In this situation, some states like California, Minnesota and New York, allow you a review by an independent board of experts. If the appeal is determined in your favor, your insurance company can't deny your claim.
If you speak up, you're almost always guaranteed a lower medical bill. "No one should be paying list prices," says Moore. "Everyone in the medical field negotiates discounts, including your health insurer. So should you."