| ||||||||||
 
Dr. Ronald P. Rogers CHIROPRACTOR Support for your body's natural healing capabilities 270-384-5554 Click here for details 
  
Columbia Gas Dept. GAS LEAK or GAS SMELL Contact Numbers 24 hrs/ 365 days 270-384-2006 or 9-1-1 Call before you dig 
Visit ColumbiaMagazine's Directory of Churches Addresses, times, phone numbers and more for churches in Adair County Find Great Stuff in ColumbiaMagazine's Classified Ads Antiques, Help Wanted, Autos, Real Estate, Legal Notices, More... 
|
DOI can review, overturn medical insurance decisions By Sherelle Roberts Pierre Frankfort, KY - Kentuckians who disagree with decisions made by their health insurance carrier about the necessity of services, treatments or medication can seek to have an outside expert review that decision, and possibly have it overturned, through a program at the Department of Insurance. Since 2000, Kentucky law gives individuals who are covered by fully insured health benefit plans the right to have an independent, medical review to assess whether the company's denial of a specific claim or requested service or treatment is justified. Reviews through DOI's Independent External Review Program are available when a recommended service or treatment is denied on the basis that it does not meet the insurer's requirements for medical necessity. "Health care is a basic human right and we want to make sure every Kentuckian has access to the quality care and treatment they deserve," said Gov. Andy Beshear. "We are taking steps to make sure every Kentuckian has health insurance and this is one more avenue to better health care outcomes in the commonwealth." "Every Kentuckian should have access to the health services they need," said Public Protection Cabinet Secretary Kerry Harvey. "The external review program provides an opportunity to have denied claims and services reconsidered by additional experts and offers individuals a chance to get the services necessary for good health." DOI Commissioner Sharon Clark says the overall rate of overturned denials by the external review program is 43% or 1,305 cases since the 19-year program began. "This program is a valuable tool to help resolve disputes between patients and their health plans. Besides being cost effective and reducing expensive litigation, the program provides another layer of patient protection, which is the primary mission of DOI." DOI's Policy Utilization Review Branch administers the program, which includes certifying, monitoring and registering the entities and agents who conduct the external reviews. Additionally, through a Memorandum of Agreement with the state's Personnel Cabinet, DOI oversees reviews associated with the Kentucky Employee Health Plan, which is the Commonwealth's self-funded health insurance arrangement administered by Anthem and CVS/Caremark. To be eligible, the following conditions must be met as outlined in state law:
This story was posted on 2020-09-18 09:38:43
Printable: this page is now automatically formatted for printing.
Have comments or corrections for this story? Use our contact form and let us know. More articles from topic News:
KYTC Reaches Milestone of 50K REAL ID-Compliant Licenses, IDs KYTC: Illegally placed signs are being removed Sunny skies, low 70s through the weekend 7-County Area Courts for Fri 18 Sep 2020 Constitution Day good day to complete your 2020 Census Schools can register for 2021 Poetry Out Loud competition Governor's Thursday update WKU announces Hilltopper Guarantee Happy 80th birthday Susan Shirley Chambers EWDC August 2020 Unemployment Report View even more articles in topic News |
 
115 Jamestown St. Columbia, KY. 270-384-2496 
  
   
 Provided by the Adair Co Fiscal Court and the Adair Co. Emergency Mgt. Agency 
|
||||||||
|
| ||||||||||
|
Quick Links to Popular Features
Looking for a story or picture? Try our Photo Archive or our Stories Archive for all the information that's appeared on ColumbiaMagazine.com. | ||||||||||
|
Contact us: Columbia Magazine and columbiamagazine.com are published by Linda Waggener and Pen Waggener, PO Box 906, Columbia, KY 42728. Please use our contact page, or send questions about technical issues with this site to webmaster@columbiamagazine.com. All logos and trademarks used on this site are property of their respective owners. All comments remain the property and responsibility of their posters, all articles and photos remain the property of their creators, and all the rest is copyright 1995-Present by Columbia Magazine. Privacy policy: use of this site requires no sharing of information. Voluntarily shared information may be published and made available to the public on this site and/or stored electronically. Anonymous submissions will be subject to additional verification. Cookies are not required to use our site. However, if you have cookies enabled in your web browser, some of our advertisers may use cookies for interest-based advertising across multiple domains. For more information about third-party advertising, visit the NAI web privacy site.
| ||||||||||
