Question: Why insurance companies have the right to deny what the doctor deems necessary treatment?
From: Sylvia G.

Answer: It sounds like you have had encountered a denial or at least questions from your insurance company about a recommended treatment. An insurer may refuse to approve a test or treatment or it may refuse coverage of the test because you did not follow one or more of its rules. The important points are to know your insurance benefits and the rules, respond to requests within the specified timeframe, document information you are given by phone, give correct insurance information to the provider, and check whether the provider is within your health plan. If there is still an issue, your physician may need to write a justification and/or further explanation to the insurance company. An insurance company may approve payment of a generic, less expensive medication unless otherwise specified by the doctor. It may consider a treatment experimental. Know the reason for the denial and follow the insurance company’s appeal procedure.