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Articles about: Legal Issues

Searchable External Appeals Database

Consumers who are enrolled in New York State regulated health plans such as fully-insured commercial plans, qualified health plans, or Medicaid managed care plans, have the right to appeal to the New York State Department of Financial Services (DFS) when their plan issues a final denial for health care services as not medically necessary, experimental/investigational

Key Terms

Read about key terms related to health insurance. Understanding these terms will help you understand how to use your coverage.

Fight a denial

What Should I Do If I Receive a Denial? If your health plan refused to pay for a medical service or denied a prior authorization request, you have the right to fight the denial through your plan’s appeal process. But before you file your appeal, there is some information you need to know. Start by

Resolving Medical Bills

Don’t understand why you received a medical bill when you have health insurance coverage? Read more.

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