They set out before dawn last spring for the nine-hour drive to Arkansas Children’s Hospital in Little Rock, where Dr. Aravindhan Veerapandiyan explained how infusions of antibodies could help Emily, now 9 years old, and her misfiring immune system.
They returned home with an appointment to start the infusions. But the Becks’ insurer, UnitedHealthcare, declined to pay for a treatment it said wasn’t medically necessary.
They decided to fight back. “I really had no idea it was going to be this hard,” April Beck said.
Health insurers process more than five billion payment claims annually, federal figures show. About 850 million are denied, according to health-policy nonprofit KFF. Less than 1% of patients appeal.
Few people realize how worthwhile those labors can be: Up to three-quarters of claim appeals are granted, studies show.
Patients who fight denied claims must marshal evidence from medical studies, navigate dense paperwork and spend hours on the phone during what is often one of the most difficult times of their lives. They debate insurers over whether a patient might ever recover from a stroke, or whether an expensive new treatment holds real promise.
