Claim Denied? Find out why.

I just learned about this on BlueSky. ProPublica’s Claim File Helper lets you customize a letter requesting the notes and documents your insurer used when deciding to deny you coverage. It was part of their investigation on what insurers were saying behind the scenes when they deny a claim.

This takes me back to 1995, when I lived in San Francisco. I worked part time as an audiologist so that I could pursue a dance career. As a result of having type 1 diabetes, I was uninsurable on the open market (Remember that? Before Obamacare?). My only option for health insurance was to join the California high risk pool. It was funded by a tobacco tax (that’s criminal all by itself). It took months to get approved because there were so many more applicants than funds. It cost $600/month and covered %60 of claims. I spent so much time and shed so many tears on the phone trying to get my claims paid.

I’m sorry that I don’t accept for-profit insurances anymore. (I couldn’t handle the denials and phone calls.) I do still accept MediCal, MediCare, Veteran’s Administration, and the Department of Rehabilitation. There’s paperwork of course, but they really look out for the people they insure, which makes me happy.

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