Estimated read time: 1-2 minutes
This archived news story is available only for your personal, non-commercial use. Information in the story may be outdated or superseded by additional information. Reading or replaying the story in its archived form does not constitute a republication of the story.
This is Fred Ball for Zions Bank, speaking on business.
Technical language and extensive information can make insurance policies difficult to fully comprehend. Frequently, when people are denied insurance coverage for certain medical bills, they do not understand why.
Claims Management, Inc. of Salt Lake City was founded in 1990 to help people with denied insurance claims and their questions. The company assists hospitals, doctors and families to appeal the claims in order to receive full payment from their health insurance.
Mary Covington, founder and president of Claims Management, has more than 35 years of experience in the insurance industry. She tells me technological advances have changed the industry over the years. Today, most insurance companies rely on computers to compare each situation to the corresponding policy. But Mary says that many of the claims need a human eye to compare the individual circumstances to the policy.
To overturn denied claims, the company gathers all the facts and information, including things such as the medical records and insurance policy and determines whether the insurance was justified in denying the claim. Mary says that since the company started 15 years ago, it has consistently discovered that 70 percent of all the claims denied are legitimate.
Over the years, Mary has gathered news articles from around the country that explain important court cases and laws regarding insurance claims. She has compiled these articles with other pertinent explanations and health files to create computer software that doctors and hospitals can use to make their own appeals.
Claims Management, Inc. has a great knowledge of the minute details and wordings of insurance policies that can be misinterpreted and misunderstood. The company plans to keep producing and selling software to guide other entities through the appeal process.
For Zions Bank, I'm Fred Ball. I'm speaking on business.
