What is a Health Care Lawyer?
A health care lawyer is a lawyer that specializes in health care issues. plans provide customers with medical care packages and insurance plans. There are numerous types of health care plans. They may also be referred to as health insurance or health care.
Health care plans can be obtained through private health insurance companies, coverage provided by an employer, or through government assistance programs. While health care plans have many advantages, they are also a common source of disputes. Health care plan disputes result in numerous lawsuits each year.
Most health care companies are large entities that earn a lot of revenue each year. Many have their own lawyers on staff or the funding to hire a lawyer to defend them in a lawsuit. The odds are not in your favor if you are attempting to fight an insurance company alone without legal representation.
Why is it Important to Have a Health Care Attorney?
If you are having any issue with your health care company, it is essential to have the help of a health care lawyer. Disputes involving health care plans many involve a number of issues, including:
- A denial of medical coverage for services or benefits;
- A refusal to authorize the insured invidiual’s hospital visit or medical procedure;
- Incorrect or excessive charges for medical services;
- Cancellation of health insurance policies without proper notice; and
- Refusal to carry over a policy when an individual changes jobs.
Disputes involving health care coverage or policies can involve many different parties, including:
- The insured individual;
- The policy provider;
- The employer;
- Medical parties; and
- Other parties.
However, in most cases, the health care dispute involves direct claims between the insured individual and their policy provider. Health care disputes can be complex and involve multiple parties, so having a lawyer’s assistance is extremely important.
What are Some Other Issues Related to Health Care Law?
There are steps you can take if you are involved in a dispute regarding your health care plan. Filing your health care plan dispute can be handled using these steps:
- Obtain notice. If you were denied coverage or had your policy cancelled, be sure to get the reason for the denial or cancellation in writing. There are laws requiring insurance companies to provide notice before denying services. Additionally, it will be easier to review that decision in or out of court if you obtain paperwork outlining the insurance company’s reason;
- An internal review. Claims may be filed through the mechanisms of the health care organization itself. This is called a consumer complaint. The health care company will provide the individual with a remedy for their losses;
- External review. In an external review, an outside agency reviews the complaint. These may be necessary when the internal review cannot fully resolve the dispute. These reviews are not available for all claims. They are usually reserved for individuals who are self-insured or who are insured through an employer-sponsorship program;
- Arbitration or Mediation. It is not unusual for an insurance contract to contain a clause that requires disputes to be resolved through arbitration or mediation. In general, insurance holders do not want to participate in arbitration because the insurance company has a pre-chosen arbitrator and no means of appeal. Mediation may be simply a means to delay trial;
- Civil Lawsuit: If the insured individual and the health insurance company cannot reach an agreement through an internal or external review, it may be possible to file a lawsuit in a civil court. In severe cases, a lawsuit may be filed before a review is filed.
No matter what option you choose to try and resolve your dispute, a health care lawyer will be an invaluable asset. Your lawyer will review your case as well as your policy, determine what may be the best path to resolution, and assist you every step of the way.
It is important to be aware that the Affordable Care Act, or Obamacare, made it illegal for insurance companies to deny an individual coverage based on a pre-existing condition. A pre-existing condition, or pre-existing illness, is any illness that the individual has prior to applying for their health care plan. Pre-existing conditions may include chronic or long-term conditions. Pregnancy may also be considered a pre-existing condition for health policy purposes.
Additionally, federal laws provide that insurances companies cannot deny coverage based on their race, national origin, sex, age, or disability. Your lawyer can review your case to determine if your insurance companies have violated federal law.
What are the Benefits of Hiring a Health Care Lawyer?
There are many benefits of hiring a health care lawyer. If you have any disputes with your health insurance provider, a lawyer will help you to resolve your claims in the best possible manner. Your lawyer can review your policy and provide you with advice regarding local laws. An experienced health care lawyer will understand the many factors involved in health care plans and help you obtain relief for any losses you have suffered.