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If you're lucky enough to have health insurance, you may think your worries are over if you become ill, require surgery, or have to make a trip to the emergency room. But your insurance company may not pay your claim. If your health insurance company denies a claim filed by a doctor or hospital for medical services to you, all is not lost. You have the right to appeal the claim denial. You can enlist your doctor and even your state government to help you in pursuing the appeal.

Review the claim and the insurance company denial.

Note the reason for denial. Common reasons include a non-covered service, use of an out-of-network provider, or a duplicate service. If the denial is for a duplicate service, check your records to make sure the claim has not already been paid. If the insurance company says you used an out-of-network provider, check the insurance company's provider list, which you can find online on the insurance company website or in your insurance enrollment packet.

Contact your doctor's office.

Ask to speak to the person who handles insurance claims. Verify that the claim was filed correctly. If the person filing the claim enters the code for a wrong service or files a duplicate claim, these could both lead to denial. If this is the case, ask the doctor's office to re-submit the claim.

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