It can be helpful to notify the Department of Insurance in your state when you receive the original denial. You can call them to request a copy of the necessary paperwork to submit your complaint. In some rare instances it may be necessary to contact the media. This is recommended only if you have tried at length to resolve the problem and have enlisted the help of your legislators and the Department of Insurance with no resolution. If you have received a denial for a procedure that must be performed within a specific time frame, you and your doctor need to communicate that to the insurance company immediately.
Most states have laws protecting patients in an emergency.
That may be different if the procedure must be started in near future. Most insurance companies already have a plan in place for such occurrences and their guidelines will be different. If you do not feel that you are making progress toward your goal and time is short, you may choose to consult an attorney to advise you of your rights and options. When to Contact the Patient Advocate Foundation You may contact the PAF at any point in the process for our advice, guidance, and support. The appeals process is very complicated.