Practice Quiz

Managed Care Nursing

Category - Patient Issues

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Which of the following is true about a patient rights regarding appealing an insurance claim denial?
  1. The patient has a right to appeal an insurance decision
  2. Insurance companies do not have to provide details regarding claim denials
  3. Insurance companies have the right to discontinue insurance without providing a reason
  4. The patient does not have rights to have a third party review
Explanation
Answer: C-The patient has a right to appeal an insurance decision and obtain details regarding the denial.

They also have the right to a third party review. Insurance companies have to provide details regarding claim denials and discontinuance of insurance reasons.
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