A new independent external review process for Pennsylvanians that have been denied healthcare coverage is touting success in it’s first six months.
In 2022, Pennsylvania passed a law that allowed the Pennsylvania Insurance Department (PID) to challenge insurance claims that were denied. In the first six months of service over 100 claims have been successfully appealed denied claims, an over 50 percent success rate.
Those who can apply for an appeal are those with commercial insurance purchased directly from an insurance company, Pennie, or employers can apply for their employees. Appeals are reviewed by doctors and healthcare professionals and if determined the original denial should be covered, the insurer will be required to do so.
According to the PID, a final decision on an appeal for coverage can be reached in less than 60 days from the application date.
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