BridgeSpan Health Company claim denials in Oregon: the federal figures
BridgeSpan Health Company denied 14.1% of in-network claims in Oregon — 2,305 claims out of 16,345. Here is what happened to the people who appealed.
What happened to appeals
| Stage | Filed | Overturned |
|---|---|---|
| Internal appeal (to BridgeSpan Health Company) | 12 | — |
| External review (independent) | — | — |
What BridgeSpan Health Company denies most
The most common denial reason recorded for BridgeSpan Health Company plans in Oregon is other reasons. How that denial is beaten →
| Denial reason | Claims | Share |
|---|---|---|
| Other reasons | 2,914 | 97.6% |
| Referral required | 41 | 1.4% |
| Service excluded from the plan | 32 | 1.1% |
What to do if BridgeSpan Health Company denied your claim
- Get the reason in writing. The denial notice must state the specific reason and the plan provision behind it. If it does not, request it — you are entitled to it free of charge.
- File the internal appeal. Generally within 180 days of the denial notice.
- If they say no again, go external. An independent organization reviews it — not BridgeSpan Health Company. Generally you have 4 months from the final internal denial. This is the step nearly everyone skips.
- Ask for expedited review if waiting would seriously jeopardise your health. That timeline is days, not months.
Everything you need for your BridgeSpan Health Company appeal: your two deadlines, the argument that fits your denial reason, an evidence checklist, and the external review request. Opens on screen the moment you pay.
Questions
Is BridgeSpan Health Company's denial rate high?
14.1% against a national average of 16% across the plans in this dataset. It is at or below average. A denial rate describes the insurer, not the merits of your claim.
Does appealing cost anything?
The internal appeal is free. External review is free under the HHS-administered federal process; where an issuer uses a contracted independent review organization or a state process, any fee is capped at $25.
Can BridgeSpan Health Company ignore the external decision?
No. External review decisions are binding on the plan.