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It sounds like great advice if your health insurance denies a claim.

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@bodhipaksa

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To everyone in a similar scenario: the tactic my doctor's office has taught me is to ask, in writing, for:

1) the name, board specialty, and license number of the making the determination the was not necessary;

2) copies of all materials they relied on to make their determination;

3) proof the doctor making the determination has maintained registration in your specific state and of their meeting all their continuing ;

4) the aggregate rate at which similar treatments are denied vs approved by the specific doctor being used for peer review.You are not entitled by to *all* of these things in most , but you're entitled to some of them, and you can always ask for them.

This is, she says, a wildly successful tactic, because if the insurance c#ompany answers them honestly, it gives you that the"doctors" making these determinations are practicing out of scope, without proper and , in areas they are not competent in.

Everyone knows this is true; it's not a secret in any way. But it's in violation of a number of regulations, and a LOT of times the company will just give up and pay the bill rather than handing you proof they're violating the regs. It's a tactic that has worked for me many, many times.

rahaeli on Bluesky posts the above.

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