Unfair Review of Claims for Medical Bills

Many health insurers require a review of claims or prior authorization requests by a nurse and a doctor, both employed by the insurer. Recent media investigations have found that some insurance company doctors are not incentivized to spend the time needed to scrutinize patients’ medical records and follow guidelines for making informed decisions about approving or denying care requests. Rather, some doctors are incentivized to deny care using a click-and-close policy, which promotes bonuses based on the quantity of cases reviewed and hence incentivizes speedy reviews. This can lead to wrongfully denied care. When this occurs, I am with my client fighting for their rights and never giving up. If you are having issues with your pre-authorization, please call me. Thank you.

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Adria Gross
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