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Health Plan Denials and Appeals

Rangos School of Health Sciences, Department of Speech Pathology, Duquesne University
Pittsburgh, PA

Janet McCarty

Health Care Economics and Advocacy, American Speech-Language-Hearing Association
Rockville, MD

Challenging health plan denials for voice treatment through appeals or advocacy efforts can pay off. This article describes the process of obtaining authorization for voice therapy, filing claims, establishing goals, preparing needed documentation, appealing claims through various levels including independent review, and developing an advocacy campaign if coverage is not offered or is very limited.