Julie Wernow

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51 appearances 1 recordings 1 series first heard Feb 2025 last heard Feb 2025

Julie Wernow’s voice in public audio — every appearance, attributed to the second.

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WSJ Your Money Briefing · Why Appealing Your Insurance-Claim Denial Could Pay Off · 13 Feb 2025 podcast

It might have been your doctor put in the wrong code or said that they were going to get it from an out-of-network pharmacy, but it turned out that you could have gotten it in an in-network pharmacy, right?

There are a lot of things that sometimes are not actually huge barriers for the insurer.

Health insurance companies might look at someone's claim and say, well, there are some things that are cheaper that they needed to try first, right?

So that's often a reason.

Sometimes they say that they don't actually think that the diagnosis is correct or that the treatment is appropriate for the patient.

And to make these decisions, they're relying on often their own policies, which are based in lots of studies and research that they've developed for pretty much any disease you can think of.

If you look at any denial that you get and you read past the part that's going to upset you, which is, hey, we're not paying for this.

You have a couple of choices.

First, you could ask your doctor to appeal it.

If you rely on your doctor to be the one to do this appeal process, which I think most people do.

You might be surprised to learn that you have better luck when you do it yourself.

And one of the reasons is you've got very busy doctors.

They've got somebody on staff who's responsible for this.

And it might take a little while before they're able to send the appeal over.

Or it's possible that they don't know your child or your loved one or your particular situation as well as you think they do.

Second, you could appeal it yourself.

First thing you want to do is make sure you actually get the denial letter.

Read through and see if it tells you what to do to appeal it and then do that yourself.

Or if you need help, ask your doctor for help.

or there are outside groups that you can actually pay to do this for you.

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