HMO medical appeals often overturned
Patients of your practice who are leery of appealing a denial of coverage from their HMO can take heart at a new study released by Georgetown University researchers for the Kaiser Family Foundation.
The study found that when people have sought independent reviews of HMO medical decisions, one-third to one-half of the decisions are overturned.
Georgetown researchers said in a recent Dallas Morning News interview that it is hard to compare external appeals processes around the nation because of various state laws. One trend, however, is that most consumers stop fighting after they have been turned down the first time.