Question:
How much of the information does insurance actually read

I have sent in pages and pages of medical and personal information, and am getting ready to write my appeal letter and was wondering just how much of the information we send in to the insurance is actually read and considered.    — [Anonymous] (posted on August 21, 2001)

August 21, 2001
Good question. I've worked in health care finance...on both ends for many years. Medical reviewers have more work on their desks than you can imagine. We don't have the time to read everything and it's quite aggravating when patients submit extraneous material. Approvals are based on clinical information and the insurers medical policy. So, don't write letters telling how you "feel", don't address "quality of life" issues, don't threaten, don't send technical articles, and don't send affadavits for friends and family memebers. Even the medical info you submit should be pertientent to wls. A letter from your therapist describing your lack of self-esteem is pointless. You should only submit pertinent *clinical* documentation and each page should have your name and policy number at the top. Your appeal letter should be clear and concise because the medical reviewer isn't going to assume anything.
   — [Anonymous]