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Insurance denial? Try calling human resources for help
The report said fewer than 1% of denied claims were appealed, with denial rates topping 50% for some plans and states.
- According to a 2025 KFF report, health insurance plans purchased through the Affordable Care Act federal marketplace denied 20% of claims in 2023, representing 1 in 5 claims overall.
- Denials often stem from coding errors, missing documentation, or duplicate claims; employers with self-funded health plans may assist with reversals, while others cannot.
- While 20% of claims were denied, consumers rarely fought back; less than 1% of denied claims were appealed, despite having typically 180 days from the EOB to file.
- Appeals can reverse denied claims, though response times vary; expect decisions within 30 days for prior authorization or up to 60 days for received services.
- Reviewing the EOB helps clarify denial reasons, while employers may offer claims assistance, legal support, or referrals to specialized benefits attorneys for further appeal assistance.
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16 Articles
16 Articles
Coverage Details
Total News Sources16
Leaning Left5Leaning Right2Center5Last UpdatedBias Distribution42% Left, 42% Center
Bias Distribution
- 42% of the sources lean Left, 42% of the sources are Center
42% Center
L 42%
C 42%
R 16%
Factuality
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