Louisiana Health Service & Indemnity Company claim denials in Louisiana: the federal figures
Louisiana Health Service & Indemnity Company denied 12.6% of in-network claims in Louisiana — 41,584 claims out of 328,768. Here is what happened to the people who appealed.
What happened to appeals
| Stage | Filed | Overturned |
|---|---|---|
| Internal appeal (to Louisiana Health Service & Indemnity Company) | 95 | 33.7% |
| External review (independent) | — | — |
What Louisiana Health Service & Indemnity Company denies most
The most common denial reason recorded for Louisiana Health Service & Indemnity Company plans in Louisiana is other reasons. How that denial is beaten →
| Denial reason | Claims | Share |
|---|---|---|
| Other reasons | 26,338 | 65.1% |
| Administrative reason | 7,392 | 18.3% |
| Service excluded from the plan | 4,219 | 10.4% |
| Provider out of network | 1,811 | 4.5% |
| Experimental or investigational | 322 | 0.8% |
| Referral required | 287 | 0.7% |
| Not medically necessary | 80 | 0.2% |
What to do if Louisiana Health Service & Indemnity 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. Louisiana Health Service & Indemnity Company overturned 33.7% of the internal appeals it received.
- If they say no again, go external. An independent organization reviews it — not Louisiana Health Service & Indemnity 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 Louisiana Health Service & Indemnity 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 Louisiana Health Service & Indemnity Company's denial rate high?
12.6% 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 Louisiana Health Service & Indemnity Company ignore the external decision?
No. External review decisions are binding on the plan.