While hiring a denied insurance claim attorney may be a good last-ditch effort, there are cheaper and more effective ways to fight a claim denial. To better inform you about your options when your insurance denies a medical claim, we’ve put together a list of services denied insurance claim attorneys provide… And ones they don’t.
List of Insurance Denial Attorney Services
When hiring a medical insurance denial attorney, here are the services you can count on:
- Advising About Legal Matters. If the law applies to your case, a denied insurance claim attorney can help you understand what your rights are. They can step in at any time in the denied claim process and will initiate contact with your insurance provider about their failure to follow the law.
- Investigating for Proof of Bad Faith. Insurance bad faith is the legal term for when your health insurance company does not meet their obligations by wrongfully denying a claim. Since denied insurance claim attorneys only intervene when your insurance provider has run afoul of the law, they typically offer investigative services. If their investigation turns up proof of bad faith, you can proceed with their legal counsel.
- Suing Insurance Companies. In the event that the medical insurance denial attorney believes you have a case for insurance bad faith, they will take care of a court case for you. Suing your insurance company for denying a claim involves the lawyer coming up with legal strategy, representing you in court, and taking care of the paperwork necessary to file a lawsuit.
What Services Denied Insurance Claim Attorneys Don’t Provide
The list of services denied insurance claim attorneys provide is limited, since they only take on cases when laws have been broken. Here are the services that you won’t be able to get from an insurance lawyer:
- Help When Lawsuits Are Not Applicable. No matter how strongly you believe that a claim was wrongfully denied, it may not have been denied in legal bad faith. In cases where a lawsuit is not applicable, a medical insurance denial lawyer will not be able to assist you in fighting your denied claim beyond encouraging you to file an appeal.
- Bill Negotiation Services. In the event that a lawsuit or denied claim appeal is not successful, you may find yourself at a dead end with a lawyer. That’s because they won’t negotiate your bill down without the presence of a legal issue. That’s when you want a medical billing advocate, like aJust, on your side to lower your medical bills.
- Free or Low-Cost Services. Perhaps the most important fact to note about denied insurance claim attorneys is the cost of their services. Unlike aJust, a medical insurance denial lawyer will likely charge high upfront fees, regardless of the outcome of your case. Then, they will take a percentage of any winnings or damages a successful lawsuit pays. With aJust, you only pay if they can successfully lower your bill, and only a fraction of the cost of your savings at that. No hidden fees, no outrageous upfront costs!
- Arbitration. Many health insurance companies include mandatory arbitration clauses in their insurance plans. If this is the case for you, not all denied insurance claim attorneys will be able to help.
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What is a Mandatory Arbitration Clause?
A mandatory arbitration clause is included in some health insurance plans to protect insurance companies from litigation. By subscribing to a plan that includes this clause, you agree to solving any disputes with your insurance provider through an arbitrator. Arbitration is not as straightforward a process as a lawsuit (but can be just as expensive), and one study by the Economic Policy Institute found that only 9% of arbitration cases are successful for patients.
You may not have heard of mandatory arbitration before, but these types of clauses are widespread, and heavily favored by health insurance companies in the US. Although proposed legislation aims to get rid of mandatory arbitration, it has not yet been enacted.
So, when you receive a denied claim from your health insurance you must either pay high fees for a lawyer who may not be able to form a legal case against your insurance company, or you take your chances with arbitration… There has to be a better way!
aJust—Your Best Insurance Lawyer Alternative
The better way starts with filling out this quick form. Unlike a denied insurance claim attorney, aJust can take on your insurance claim denial even when your insurance company hasn’t broken the law. Whether you’re unsure of how to proceed once you are notified of the denial, or you’ve exhausted your internal appeal options with your insurance provider, aJust can take over and fight to lower your medical bills.
Good luck getting a denied insurance claim attorney to do that!