AP News
(2010-07-20 08:40:02)
Obama administration spells out rights of consumers to appeal health care claim denials
The Obama administration is spelling out new rights for consumers to appeal to a neutral referee if their health insurance company denies a claim.
Federal regulations issued Thursday will require a two-stage process.
First, consumers will appeal directly to the insurer. If they get a second denial, they can appeal to an independent reviewer whose decision is binding. Consumers can also use the system if their coverage gets canceled.
Many health plans already have a system for appeals, although not as friendly to consumers. The number of people covered by the new safeguards will grow from about 40 million next year to as many as 88 million by 2013.
The rules are part of President Barack Obama's health care overhaul law.

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