30 Second Insurance Tips©

Tip 165- Independent Review Process

From one of several newspapers I regularly read, I bring to your attention a weeklong series entitled “Insurance Nightmares,” chronicling consumers seemingly cheated by their health insurers.

A child with a rare genetic eating disorder denied specialized – potentially lifesaving – treatment. A Good Samaritan badly burned trying to save a life in a traffic accident, receiving out of network emergency care not covered by his insurer.

Two observations.

Independent review found that in many of the cases sited, providers overcharged or over treated consumers. We would do well to remember Wisconsin insurance regulations provide a process for just that kind of review.  Click here for details.

We would also do well to remember that insures pay claims with our premium dollars. We need to find a balance between claims paid without review – as in, unaffordable premiums – and a fragmented system that leaves consumers holding the bag at the time of claim, when they are most vulnerable to literal and emotional bankruptcy!