Skip to content

Navigating Insurance: How We Manage the Appeal Process for Patient Care

Insurance for individuals with a number of medical needs can be complex, confusing and ever-changing. When every aspect of a patient’s care needs to be processed through their insurance provider, keeping up with its status might not always be manageable – and navigating something like an appeal process in the case of a claim denial isn’t common knowledge.

We know as the parent of a child with medical complexities, your days are busy – so when issues arise with your insurance coverage, we do what we can to manage them for you. One claim response we may see from insurance companies regarding patient care is a denial. When this happens, PHS billers and customer service representatives work through an appeal process, meaning they are working to provide more information or prove of necessity for a product or service in hopes of changing the denial.

To understand these steps better, we sat down with infusion billing specialist Claudia Rodriguez and admissions coordinator Aubry Banken, who both work with denials and the appeal process each day in their roles. If you have any questions about this process related to your child’s care, you can always call 651-642-1825 and ask to speak to billing or customer service.

Originally published: March 14, 2017