What Happens If The Hmo Denies My Claim For Payment Of Services?

The company must have an appeal process for you to follow. There is a first and second level appeal process in which you and your physician can present documentation showing your reasons for requesting the proposed treatment. Your appeal must be in writing and the insurance company has up to 30 days to complete an investigation on each level of grievance. You also have the right to contact the Missouri Department of Insurance anytime during this process. The toll free number for the Missouri Department of Insurance is 1­800­726­7390.

The information on this page is meant to provide a general overview of the law. The laws in your state and/or city may deviate significantly from those described here. If you have specific questions related to your situation you should speak with a local attorney.

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