When a health insurance company is deciding whether to pay for your medical treatment, the company generates a file around your claim. All the records associated with your case should be part of your file. This includes documents explaining the reasons your claim was denied.
You have a right to see this file. Federal regulations require most health insurance plans to give people an opportunity to review documents related to their claim for free. So if your insurer talks to your doctor, if a nurse takes notes, or if two people speak about it on the phone, all of those records should be available to you.
“It’s a treasure trove of information,” said Juliette Forstenzer Espinosa, a health lawyer and senior lecturer of health policy at George Washington University. “But most people have no idea how to get it.”
