20 years later: How Ohio's review process for appealing healthcare coverage decisions has fared

Kelly Gooch -

Ohio patients have recovered millions of dollars over the last two decades after appealing denied coverage from healthcare insurance companies or providers, according to The Columbus Dispatch.

Ohio has allowed patients to appeal denied benefits and services since 1999, when the state enacted its external review law. The 2010 ACA expanded that right nationally, and Ohio's law was updated in 2011, the newspaper reported.

Under the law, residents who disagree with a denial or reduced benefit from their insurer, or charges from their healthcare provider, may appeal decisions and potentially go through external review.

Overall, the Ohio Department of Insurance or an independent review organization reviewed 7,012 cases between 1999 and 2017, resulting in patients recovering more than $21.6 million in previously denied healthcare benefits and services, according to The Dispatch, which cited information from the state insurance department.

Read more about Ohio's efforts here.

 

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