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Navigating the complexities of health insurance disputes can be overwhelming, especially during a time of need. The Sasser Law Firm has extensive experience advocating for clients facing health insurance denials. Our team understands the intricacies of ERISA law, the nuances of Marketplace plans, and the importance of timely appeals and external reviews.
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FIGHTING FOR YOUR RIGHTS EVERY STEP OF THE WAY
If you receive your health insurance through your or your spouse’s employer, it is likely subject to The Employee Retirement Income Security Act of 1974 (ERISA). ERISA is a complex federal statute that deals with employee benefits plans and, importantly, how benefit denials can be made and challenged. Its important to work with an attorney before you submit any ERISA appeal. The information provided on appeal will greatly impact your likelihood of success if you have to move forward to filing a lawsuit. Don’t wait to hire an attorney until it is too late.
Some health insurance plans, including those purchased on the Health Insurance Marketplace are exempt from ERISA. Its important to find a firm like ours, who knows the nuances of the law and can help you assess all possible paths to get the insurance company to pay for covered services.
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YOUR TRUSTED NAVIGATORS
In addition to an appeal, under the Affordable Care Act, you may be entitled to seek an “External Review” of your claim denial. It is important to talk with a knowledgeable attorney (like us) as soon as you receive notice that the insurer is denying your claim, so that you can preserve all possible routes for an appeal. We offer complementary consultations on all insurance disputes.
Often, health insurance policies cover benefits for medical services which are deemed “medically necessary.” The legal definition of “medically necessary” may be more beneficial to you than you realize. Contact us to review the denial of your coverage.
We have specific experience challenging denials of coverage for persons receiving long-term care. Don’t let the insurance company refuse to provide the health coverage you purchased. Contact us to see if we are able to help with your claim.
This coverage includes:
- Private Duty Nursing
- Home Health Care
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Empowering People In Powerless Situations
In many cases, if the appeal is not handled correctly, succeeding through litigation will be very difficult if not impossible. For this reason, the sooner you consult with an employee benefits attorney, the better your chances for success. We offer complimentary consultations for all employee benefit and insurance dispute claims.