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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. Here are some Do-it-Yourself appeal guides to help you: Medical Necessity DIY: (English) (Spanish) Not a

Resolving Medical Bills

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

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  • Call our helpline at (888) 614-5400 Monday to Friday, 9am to 4pm,
  • or email cha@cssny.org.