Concepedia

Coverage Appeal Determinations

Coverage Appeal Determinations is a formal decision-making framework within the domain of insurance and healthcare claims appeals that specifies the criteria, processes, and outcomes used to evaluate and resolve challenges to the denial or limitation of coverage for requested medical services or benefits.

5

Publications

98

Citations

13

Authors

12

Institutions

Publications per year

2017–2026

1

Parents

Publications

5

The "Hassle Factor"

Rachel M. Werner, G. Caleb Alexander, Angela Fagerlin et al. · Archives of Internal Medicine · 2002 · 38 citations

, , +12

Enrollee Appeals of Preservice Coverage Denials at 2 Health Maintenance Organizations

David M. Studdert, Carole Roan Gresenz · JAMA · 2003 · 19 citations

, , +13

Scientific Expertise and the Balance of Political Interests: MEDCAC and Medicare Coverage Decisions

Stéphane Lavertu, D. Eric Walters, David L. Weimer · Journal of Public Administration Research and Theory · 2011 · 19 citations

, , +16

What's Wrong With the ERISA Vacuum?

Lawrence O. Gostin · JAMA · 1993 · 11 citations

, , +8

Evidence supporting FDA approval and CMS national coverage determinations for novel medical products, 2005 through 2016

Aliya C. Roginiel, Sanket S. Dhruva, Joseph S. Ross · Medicine · 2018 · 11 citations · Full text

, , +17

1–5 of 5

Authors

13

  1. SL
    Stéphane Lavertu

    The Ohio State University, United States

    1 publications · 19 citations

    1

    h-index

  2. AF
    Angela Fagerlin

    University of Michigan, United States

    1 publications · 38 citations

    1

    h-index

  3. GC
    G. Caleb Alexander

    University of Chicago, United States

    1 publications · 38 citations

    1

    h-index

  4. DM
    David M. Studdert

    The University of Melbourne, Australia

    1 publications · 19 citations

    1

    h-index

  5. PA
    Peter A. Ubel

    University of Michigan, United States

    1 publications · 38 citations

    1

    h-index

1–5 of 13

Institutions

12

  1. University of Michigan

    Ann Arbor, United States

    2 h-index

    3 publications

    95 citations

  2. VA Connecticut Healthcare System

    West Haven, United States

    1 h-index

    1 publications

    11 citations

  3. The Ohio State University

    Columbus, United States

    1 h-index

    1 publications

    19 citations

  4. California University of Pennsylvania

    California, United States

    1 h-index

    1 publications

    38 citations

  5. Yale University

    New Haven, United States

    1 h-index

    2 publications

    22 citations

  6. Harvard University

    Cambridge, United States

    1 h-index

    1 publications

    19 citations

  7. University of Wisconsin–Madison

    Madison, United States

    1 h-index

    1 publications

    19 citations

  8. University of Pennsylvania

    Philadelphia, United States

    1 h-index

    1 publications

    38 citations

1–8 of 12

Venues

  1. JAMA

    2 publications · 30 citations

    2

    h-index

  2. Archives of Internal Medicine

    1 publications · 38 citations

    1

    h-index

  3. Journal of Public Administration Research and Theory

    JPART · 1 publications · 19 citations

    1

    h-index

  4. Medicine

    1 publications · 11 citations

    1

    h-index

1–4