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Originally Posted by
KB21
I'm convinced that insurance companies deny all claims initially just to see if you will not appeal. I have to deal with health insurance companies. I had a patient recently who has migraine headaches, is intolerant to tryptans, allergic to the monoclonal antibody meds, and has had an increase in her headaches since getting the covid vaccine. I gave her some samples of a different kind of headache medication, and it worked for her. When I sent a prescription, her insurance denied it. When I appealed, they sent a list of questions where, if they had read my office note, had already been answered.
Depends on the type of insurance you talking about and the carrier, I guess. I worked 20 years for specialized physical damage and inland marine claims for about 30 different carriers, less than 1% was ever denied and NEVER denied until after our initial investigation. Never had a carrier deny the claim upon the receipt of the claim. Again, this is property physical damage claims. Still do storm claim work and the carriers I worked for actually expand coverages during a storm event and they gave out way above policy language during Katrina.
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