What does peer to peer mean?
1 : relating to, using, or being a network by which computers operated by individuals can share information and resources directly without relying on a dedicated central server (see server sense 6) In peer-to-peer computing, every client can be a server.
What is a peer to peer prior authorization?
Peer-to-peer review is a process in which an ordering physician discusses the need for a procedure or drug with another physician who works for the payer in order to obtain a PA approval or appeal a previously denied PA.
Why do insurance companies deny coverage?
Denied Claims Even if you pay your premiums regularly and on time, an insurance company may not pay out claims you report. Finally, the insurance company may find the damage to have been caused by the insured which may allow them to deny the claim.
Why would an insurance company deny coverage?
Car insurance companies are more likely to deny insurance to people they believe are more likely to file a claim. Insurance companies frequently deny coverage if the applicant has a recent history of accidents, a series of minor traffic tickets or a serious infraction such as a DUI.
Which insurance company denies the most claims?
Top 10 Insurance Companies for Claim Denial TrickeryAIG.Conseco.State Farm.United Health Group.Torchmark.Farmers Insurance Group.WellPoint.Liberty Mutual.
What pre existing conditions are not covered?
Under the Affordable Care Act passed in 2010, “Health insurers can no longer charge more or deny coverage to you or your child because of a pre-existing health condition like asthma, diabetes, or cancer. Once you have insurance, they can’t refuse to cover treatment for your pre-existing condition.”
What are the most common pre existing conditions?
If you have or have ever had acne, anxiety, depression, diabetes, asthma, sleep apnea, COPD, obesity, clogged arteries (atherosclerosis), or cancer, then you have had one of the ten most common pre-existing conditions.