In this interview, Edison Guzman speaks with Adria Gross, an insurance advocate, about navigating medical claim denials. Adria explains the common reasons for denials, such as insurance companies rejecting claims without proper review or doctors submitting bills late. She outlines the steps individuals should take when faced with a denial, including contacting the insurance company to understand the reason, appealing the decision, and, in some cases, working with their doctor to resolve issues. Adria emphasizes that patients often need to build a strong case when appealing denials and highlights how deadlines play a crucial role in the claims process.
Adria also shares insights about various pitfalls individuals face during the appeals process, such as missing key information like a provider’s tax ID or procedure codes. She offers guidance on how to avoid these issues and encourages people not to give up on appealing unjust claim denials. As an insurance advocate, Adria helps individuals through these complex processes and offers her contact information for further assistance. The interview concludes with Adria’s motivating advice to “fight for your rights.”