American Patients Association Launches First Automated, Online Process for Consumers to Appeal Denied Medical Claims.Business Editors/High-Tech, Health & Medical Writers CORAL GABLES Coral Gables, city (1990 pop. 40,091), Miami-Dade co., SE Fla., SW of Miami; inc. 1925. Founded at the height of the Florida land boom, Coral Gables is a noted planned city, with tree-lined boulevards and Mediterranean-style buildings. , Fla.--(BW HealthWire)--Jan. 16, 2002 Easy-to-Use, Inexpensive Method to Revolutionize rev·o·lu·tion·ize tr.v. rev·o·lu·tion·ized, rev·o·lu·tion·iz·ing, rev·o·lu·tion·iz·es 1. To bring about a radical change in: Television has revolutionized news coverage. 2. Medical Appeals Process American Patients Association, a consumer advocacy group that researches and provides affordable healthcare solutions, today announced the launch of an easy-to-use service that processes consumers' medical insurance appeals online for a one-time fee of $12.95 per appeal. This service, previously offered only to doctors and medical providers, is available exclusively on the American Patients Association's website at http://www.ameripat.com. "More than 600 million medical claims are denied every year, jeopardizing medical treatment and putting consumers at financial risk," said Ileana Bravo BRAVO Cardiology A clinical trial–Blockade of the GP IIB/IIIA Receptor to Avoid Vascular Occlusion– which evaluated lotrafiban in preventing strokes and acute MI. See GP IIB/IIIA. , Emmy-award winning journalist, consumer healthcare advocate and founder of the American Patients Association. "Surveys estimate 40 percent of consumers who have experienced problems with their medical insurance don't realize they have the right to appeal a denied claim, in some states as many as three or more times! Those who appeal on their own find the traditional process so frustrating frus·trate tr.v. frus·trat·ed, frus·trat·ing, frus·trates 1. a. To prevent from accomplishing a purpose or fulfilling a desire; thwart: they often give up." The American Patients Association (Ameripat) estimates a consumer spends an average of three and a half hours appealing a denied medical claim, usually during weekday hours when the insurance company is open for business. The electronic appeal service available on Ameripat's website takes only minutes to complete and is available to consumers 24-hours a day. "Our simple process improves the chance of success by ensuring that the appeal is filed correctly the first time, eliminating delays caused by submitting incomplete information. Time is critical when it comes to a denied medical service," said Bravo. Consumers can appeal a denied medical claim to HMOs, group health insurance plans, and Medicare Medicare, national health insurance program in the United States for persons aged 65 and over and the disabled. It was established in 1965 with passage of the Social Security Amendments and is now run by the Centers for Medicare and Medicaid Services. by logging onto http://www.ameripat.com and completing a standardized standardized pertaining to data that have been submitted to standardization procedures. standardized morbidity rate see morbidity rate. standardized mortality rate see mortality rate. electronic form that requires only the insured's membership ID and denied claim number. The software automatically files the appeal, applying all specific state and federal rules. Users can track the appeals process online and should receive the results directly from their insurance company within 30-45 days. If the claim is denied again, the system enables users to escalate es·ca·late v. es·ca·lat·ed, es·ca·lat·ing, es·ca·lates v.tr. To increase, enlarge, or intensify: escalated the hostilities in the Persian Gulf. v.intr. their appeal to the next review stage or file a complaint with the regulatory authority Noun 1. regulatory authority - a governmental agency that regulates businesses in the public interest regulatory agency administrative body, administrative unit - a unit with administrative responsibilities at no additional charge. American Patients Association has the exclusive rights to the technology platform developed by eAppealSolutions, the nation's only online healthcare appeal clearinghouse. eAppealSolutions currently offers its medical appeals service to more than 200,000 doctors and medical professionals at some of the nations leading hospitals and healthcare providers, including Web MD, Alliance One, Chartwell and Medibillers. Former senior executives of one of the nation's largest HMOs founded eAppealSolutions. "Providers have experienced success rates in excess of 40 percent using our appeals systems," said Dr. William Kirsch kirsch n. A colorless brandy made from the fermented juice of cherries. [French, short for German Kirschwasser; see kirschwasser. , president of eAppealSolutions. "This software empowers consumers by giving them an easy way to address their insurance disputes if a claim for payment has been denied or a request for a medical service refused." According to according to prep. 1. As stated or indicated by; on the authority of: according to historians. 2. In keeping with: according to instructions. 3. Faulkner & Gray's Health Data Directory, more than six billion insurance claims were filed last year. American Patients Association estimates 10 percent of these claims were denied and can be appealed. In a study conducted by the Kaiser Family Foundation The Henry J. Kaiser Family Foundation (KFF), or just Kaiser Family Foundation, is a U.S.-based non-profit, private operating foundation headquartered in Menlo Park, California. , more than 51 percent of respondents In the context of marketing research, a representative sample drawn from a larger population of people from whom information is collected and used to develop or confirm marketing strategy. said they had a problem with their health care coverage, yet 40 percent did not know they had the right to appeal. About American Patients Association The mission of the American Patients Association is to educate consumers about critical healthcare issues that impact their daily lives and empower empower verb To encourage or provide a person with the means or information to become involved in solving his/her own problems them to exercise their rights with simple, affordable solutions. Founded by Emmy-award winning journalist and consumer healthcare advocate Ileana Bravo, American Patients Association offers consumers an easy-to-use and affordable vehicle to appeal denied health insurance claims over the Internet. For more information visit http://www.ameripat.com. About eAppealSolutions Founded in 1999 by former health insurance experts, eAppealSolutions (http://www.eAppealSolutions.com) is the nation's only online healthcare appeal clearinghouse. The Company simplifies the appeals process, helping providers, consumers and insurance companies save time and money in resolving healthcare denials. eAppealSolution's services are available to more than 200,000 doctors and medical professionals and to consumers via the American Patients Association at www.ameripat.com. |
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