Appeals - Is is 60 or 90 days to hear back from insurnace?
Every insurance company outlines their appeal procedures in your Summary Plan Description booklet, and also in your denial letter.
ERISA law allows 60 days, and then the insurance company can have another 60 days, but they need to write you and let you know they need an extension of time in order to determine their liability.
Some insurance companies have their own time standards that extend beyond the ERISA deadlines.
It is important that everyone reads, and understands their Summary Plan Description booklet.
Fight the good fight!
Roberta
Thanks, I pulled out the denial letter and it states I have 60 days to appeal.
I have NEVER had any summary plan booklet. They claim my husbands company don't have one. Just some stupid thing called. A glance at your insurance coverage.It's this over sized paper that just tells me how much it covers for Doctors visit and hospital stays.
Believe it or not I called my husbands HR and they had nothing showing what they covered. Called two different BCBS numbers and both ladies said, sorry don't have anything.
This is why I called the 800 number and asked and they sent me the guide lines on what I had to do in order to get approved.
Donna