LANSING, Mich. — The Michigan Department of Insurance and Financial Services (DIFS) announced the department is prioritizing health insurance appeals related to coverage for coronavirus testing and treatment, according to a news release.
“All consumers have the right to an independent external review if their health insurance claim is denied,” said DIFS Director Anita Fox. “Those claims with urgent health needs with COVID-19 treatment denials, are being given priority.”
The department said when a consumer contacts the department about a health insurance claim denial, it will review the claim to "determine eligibility for review under the Patient's Right to Independent Review Act (PRIRA)."
The department said if a claim involves issues of medical necessity, the department will work with an independent review organization to evaluate whether the denial was appropriate.
“Consumers with questions about a health insurance denial, loss of health coverage due to job loss, or other health insurance concerns, should contact DIFS,” added Fox. “The DIFS’ call center and analysts are available from 8 a.m. to 5 p.m., Monday through Friday, to assist Michiganders with their non-Medicaid health insurance questions.”
The department said consumers can file a request for external review by visiting the DIFS website.
If you have questions about the PRIRA process, you are asked to call DIFS at 877-999-6442.
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