About This Episode
A deep dive into strategies providers can use to fight back against improper insurance claim denials. Thomas Force discusses the most common denial reasons, how to identify patterns of bad-faith denial behavior, and the legal tools available to providers when payers act improperly or in violation of their plan obligations.
Key Topics Covered
Most common reasons claims are denied
Distinguishing technical denials from bad-faith denials
Internal appeals vs. external review
ERISA claims and self-funded plan strategies
How to document a pattern of insurer misconduct
When denial behavior crosses into legal liability
