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Health Care Appeals Regarding Arizona Health Insurance Policies

Health Care Appeals

If, after you have purchased a health insurance policy, you disagree with the insurance company regarding a denial of a claim or a request for a medical procedure, you can file a formal appeal. The first step is for the consumer to appeal directly to the insurance company. If the insurer denies a formal appeal, the consumer has 30 days to request an external, independent review. Those appeals are referred to the Arizona Department of Insurance or to an independent medical reviewer approved by the Insurance Department. An Expedited Medical Review is available when denial of a treatment or service could cause a negative change in your medical condition. A free brochure that spells out in detail how the Health Care Appeals process works is available from the Arizona Department of Insurance.